Individual
DR. EILEEN MARIE DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
18501 ROTUNDA DR STE 200, DEARBORN, MI 48124-3891
(313) 996-1960
(313) 996-1965
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1863
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
4304065585
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301065585
MEDICAL LICENSE, MI
MI
05
—
4409463
—
MI
Enumeration date
06/27/2006
Last updated
10/22/2020
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