# JOHN EID SOLE MBR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922695303
- **Authorized official:** MR. JOHN EID (DIRECTOR)
- **Authorized official phone:** (586) 907-1092

## Contact information

- **Practice address:** APPLEWOOND DR SHELBY, BROOKS, MI 53912
- **Practice address phone:** (586) 907-1092
- **Mailing address:** APPLEWOOND DR SHELBY, BROOKS, MI 53912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 12/31/2020
- **Last updated:** 12/31/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | E200429772052 | — | MI |