Provider Demographics
NPI:1164737029
Name:EINAS JOSEPH M D P C
Entity Type:Organization
Organization Name:EINAS JOSEPH M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EINAS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:248-250-2133
Mailing Address - Street 1:107 N MITCHELL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-1832
Mailing Address - Country:US
Mailing Address - Phone:231-775-0374
Mailing Address - Fax:
Practice Address - Street 1:119 S WASHINGTON ST STE 1
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-6423
Practice Address - Country:US
Practice Address - Phone:248-969-2871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081571208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty