Individual
DR. EVAN BRADLEY FONGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 MACK AVENUE, DETROIT, MI 48201
(313) 578-5000
(313) 578-6379
Mailing address
400 MACK AVENUE, DETROIT, MI 48201
(313) 578-5000
(313) 578-6379
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301087817
MI
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
4301087817
MI
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
4301087817
MI
Other
Enumeration date
06/06/2007
Last updated
04/13/2026
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