Eadie, Reginald J

Eadie, Reginald J is an individual health care provider with primary practice located at 6071 W Outer Dr , Detroit MI 48235-2624. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Eadie, Reginald J can be contacted via phone (313) 745-2780.

Contact Information

Primary practice address
6071 W Outer Dr Detroit MI 48235-2624
Phone: (313) 745-2780
Fax: (313) 745-1520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 4301065909 Michigan
Allopathic & Osteopathic Physicians / General Practice 208D00000X 4301065909 Michigan

Profile Details

NPI number 1902866734
LBN Legal business name Eadie, Reginald J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Feb 18th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902866734 NPPES
Michigan MEDICAID 104184200
Michigan MEDICAID 104205660
Michigan Other RE065909

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