Organization
EASTSIDE INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ECKENWILER (OFFICE MANAGER)
(586) 552-1710
Entity
Organization
Contact information
Practice address
28315 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1687
(586) 552-1710
(586) 552-1715
Mailing address
28315 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1687
(586) 552-1710
(586) 552-1715
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301049083
MI
Other
Enumeration date
08/31/2006
Last updated
07/21/2011
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