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Organization

E J DAROS DO PC

Active
Other names
FAMILY DOCS CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EVTISHIOS JAMES DAROS D.O. (PRESIDENT)
(810) 603-0990
Entity
Organization

Contact information

Practice address
8275 HOLLY RD, SUITE 1, GRAND BLANC, MI 48439-2442
(810) 603-0990
(810) 603-1678
Mailing address
8275 HOLLY RD, SUITE 1, GRAND BLANC, MI 48439-2442
(810) 603-0990
(810) 603-1678

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ED007048
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
$$$$$$$$$
SSN
MI
01
080B511230
BCBSM
MI
01
1003800350
NPI INDIVIDUAL
MI
01
1316944333
NPI INDIVIDUAL
MI
01
1841284437
NPI INDIVIDUAL
MI
05
2095522
MI
05
4613396
MI
05
4614320
MI
01
AD013144
STATE LICENSE NUMBER
MI
01
DM076048
STATE LICENSE NUMBER
MI
01
ED007048
STATE LICENSE NUMBER
MI
Enumeration date
04/10/2007
Last updated
05/21/2020
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