Provider Demographics
NPI:1851382006
Name:GARCIA, EDUARDO J (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:J
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3290 W. BIG BEAVER
Mailing Address - Street 2:SUITE 444
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-2914
Mailing Address - Country:US
Mailing Address - Phone:248-816-9200
Mailing Address - Fax:248-816-1017
Practice Address - Street 1:3290 W. BIG BEAVER
Practice Address - Street 2:SUITE 444
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2914
Practice Address - Country:US
Practice Address - Phone:248-816-9200
Practice Address - Fax:248-816-1017
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066491207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M43750-001Medicare PIN
MI0M43750006Medicare PIN
MI0M43750006Medicare PIN