Individual
MARK E REDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17400 W 13 MILE RD, BEVERLY HILLS, MI 48025-5439
(248) 712-4120
(248) 792-5243
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
4301066003
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160H229520
BCBSM
MI
01
—
364509477
TAX ID
MI
05
—
4793740
—
MI
05
—
4944639
—
MI
01
—
7067400
AETNA
MI
01
—
MR066003
LICENSE
MI
Enumeration date
01/05/2006
Last updated
08/18/2023
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