Provider Demographics
NPI:1972672103
Name:EFROS, ARTHUR A (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:A
Last Name:EFROS
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 1:28625 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 213
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1828
Mailing Address - Country:US
Mailing Address - Phone:248-354-9666
Mailing Address - Fax:248-354-6159
Practice Address - Street 1:28625 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 213
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1828
Practice Address - Country:US
Practice Address - Phone:248-354-9666
Practice Address - Fax:248-354-6159
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301040008207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700H273300OtherBLUE SHIELD, GROUP
MI1106301321OtherBLUE SHIELD, INDIVIDUAL
MI1972672103Medicaid
MI1972672103Medicaid