Provider Demographics
NPI:1144212325
Name:ECKEL, MARGARET (DO)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:ECKEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22646 E 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1951
Mailing Address - Country:US
Mailing Address - Phone:586-498-4800
Mailing Address - Fax:586-498-4830
Practice Address - Street 1:22646 E 9 MILE RD
Practice Address - Street 2:SUITE A
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1951
Practice Address - Country:US
Practice Address - Phone:586-498-4800
Practice Address - Fax:586-498-4830
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301110Medicaid
MI4301110Medicaid
MIH12031Medicare UPIN