Provider Demographics
NPI:1508519075
Name:ESSENTIAL CARE FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:ESSENTIAL CARE FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-280-2100
Mailing Address - Street 1:21603 E 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1636
Mailing Address - Country:US
Mailing Address - Phone:586-280-2100
Mailing Address - Fax:833-496-1920
Practice Address - Street 1:21603 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1636
Practice Address - Country:US
Practice Address - Phone:586-280-2100
Practice Address - Fax:586-210-8808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty