Organization
KAISER MEDICAL CENTER PC
Active
Organization
KAISER MEDICAL CENTER PC
Active
Other names
Kaiser medical center
Organization subpart
No
Provider details
NPI number
Authorized official
ELANGO EDHAYAN MD (DIRECTOR)
(313) 549-9595
Entity
Organization
Contact information
Practice address
24025 GREATER MACK AVE STE 103, SAINT CLAIR SHORES, MI 48080-4311
(586) 806-3220
(586) 350-0099
Mailing address
24025 GREATER MACK AVE STE 103, SAINT CLAIR SHORES, MI 48080-4311
(586) 806-3220
(586) 350-0099
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
Primary
MK058470
MI
Other
Enumeration date
09/24/2007
Last updated
05/06/2026
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