| Eastlake Medical Center | |
|
646 Chene St Detroit MI 48207-3979 | |
| (248) 747-3425 | |
| Not Available |
| Full Name | Eastlake Medical Center |
|---|---|
| Speciality | General Practice |
| Location | 646 Chene St, Detroit, Michigan |
| Authorized Official Name and Position | Bianca Felicia Dooley (PRESIDENT CEO) |
| Authorized Official Contact | 2487473425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastlake Medical Center 17520 W 12 Mile Rd Ste 116 Southfield MI 48076-1907 Ph: (248) 443-6711 | Eastlake Medical Center 646 Chene St Detroit MI 48207-3979 Ph: (248) 747-3425 |
| NPI Number | 1821267832 |
|---|---|
| Provider Enumeration Date | 02/23/2008 |
| Last Update Date | 02/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821267832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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