Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 4301044474 | MI |
NPI | 1538106026 |
---|---|
Provider Name | Michael J Eadie |
First Address | Richmond, MI 48062-2505 |
Second Address | Richmond, MI 48062-2505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 24/12/2008 |