Provider Demographics
NPI:1356217517
Name:MICHIGAN ANESTHESIA TEAM, PLLC
Entity type:Organization
Organization Name:MICHIGAN ANESTHESIA TEAM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-306-6535
Mailing Address - Street 1:6240 RASHELLE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3938
Mailing Address - Country:US
Mailing Address - Phone:810-620-7889
Mailing Address - Fax:810-243-8434
Practice Address - Street 1:6240 RASHELLE DR STE 101
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3938
Practice Address - Country:US
Practice Address - Phone:810-620-7889
Practice Address - Fax:810-243-8434
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHIGAN ANESTHESIA TEAM, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty