Individual
BRIAN L EDELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3190
Mailing address
PO BOX 55114, DETROIT, MI 48255
(248) 858-3197
(248) 858-3148
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
077513
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4753870
—
MI
01
—
P00267382
RR MCR
MI
Enumeration date
05/23/2006
Last updated
06/14/2024
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