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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