Organization
BOBBI EDWARDS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOBBI EDWARDS MD (PRESIDENT)
(248) 483-8486
Entity
Organization
Contact information
Practice address
24901 NORTHWESTERN HWY, SUITE 214, SOUTHFIELD, MI 48075
(248) 483-8488
(248) 483-8489
Mailing address
19315 W 10 MILE RD, SOUTHFIELD, MI 48075-6596
(248) 483-8488
(248) 325-8967
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BE063204
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0706339290
BLUE CROSS OF MI
MI
01
—
264628YMPJ
MARYLAND DC MEDICARE PIN NUMBER
DC
Enumeration date
09/06/2007
Last updated
09/06/2018
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