Individual
DR. EIAD KSEIBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7633 E JEFFERSON AVE, SUITE 360, DETROIT, MI 48214-3730
(313) 499-4985
(313) 499-4955
Mailing address
4973 CARLSON PARK DR, TROY, MI 48098-4647
(248) 722-8029
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
4301077122
MI
207RP1001X
Pulmonary Disease Physician
4301077122
MI
207RS0012X
Sleep Medicine (Internal Medicine) Physician
4301077122
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-0502282-2
BCBS PIN NUMBER
MI
05
—
1356363311
—
MI
01
—
700E012740
BCBS GROUP NUMBER
MI
Enumeration date
07/25/2006
Last updated
05/27/2009
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