Individual
EVTISHIOS JAMES DAROS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8275 HOLLY RD, SUITE1, GRAND BLANC, MI 48439-2442
(810) 603-0990
Mailing address
8275 HOLLY RD, SUITE1, GRAND BLANC, MI 48439-2442
(810) 603-0990
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ED007048
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2095522
—
MI
01
—
5253833
BCBS
MI
Enumeration date
07/05/2005
Last updated
07/09/2007
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