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Dr. Reginald J Eadie, MD
General Practice Physician in Detroit, Michigan
NPI 1902866734

Reginald J Eadie is a General Practice Physician based in Canton, MI. Reginald J Eadie practices in Detroit, MI and has the professional credentials of MD. The NPI Number for Reginald J Eadie is 1902866734 and holds a License No. 4301065909 (Michigan).

The current practice location address for Reginald J Eadie is 6071 W Outer Dr, Detroit, MI and can be reached out via phone at 313-745-2780 and via fax at 313-745-1520.

Location: 6071 W Outer Dr, Detroit, MI, 48187-1283
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902866734
Provider Name
Reginald J Eadie
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
6071 W Outer Dr, Detroit, MI, 48187-1283
Phone Number
313-745-2780
Fax Number
313-745-1520
Provider Enumeration Date
03/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
104184200 05 MI
104205660 05 MI
RE065909 01 MI BC/BS OF MI
institution
Provider Business Practice Location Address Details
Address
6071 W Outer Dr
City
Detroit
State
Michigan
Zip
48235-2624
Phone Number
313-745-2780
Fax Number
313-745-1520
person
Provider Business Mailing Address Details
Address
6071 W Outer Dr
City
Detroit
State
Michigan
Zip
48235-2624
Phone Number
313-745-2780
Fax Number
313-745-1520
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Emergency Medicine
Speciality
Emergency Medical Services
Taxonomy
207PE0004X
License No.
4301065909 (Michigan)
Definition
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
4301065909 (Michigan)
Definition
Definition to come...
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