DR. REGINALD J EADIE M.D. NPI 1902866734

Emergency Medicine (Emergency Medical Services) in Detroit, MI

About REGINALD EADIE

Reginald Eadie is a provider in Detroit, MI. The NPI number assigned to this provider is 1902866734. The practitioner's primary taxonomy code is Emergency Medicine (207PE0004X). The provider is registered as an individual and their NPI record was last updated 9 years ago.

NPI

1902866734

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDR. REGINALD J EADIE M.D.
Provider Location Address6071 W OUTER DR DETROIT, MI 48235 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address6940 KENNESAW RD CANTON, MI 48187 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date03-24-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date02-18-2009 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DR. REGINALD J EADIE M.D.
6071 W OUTER DR
DETROIT, MI
ZIP 48235
Phone: (313) 745-2780
Fax: (313) 745-1520

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Mailing Address

DR. REGINALD J EADIE M.D.
6940 KENNESAW RD
CANTON, MI
ZIP 48187
Phone:

Primary Taxonomy

Taxonomy Code207PE0004X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationEmergency Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationEmergency Medical Services
License No.4301065909
License StateMI
Taxonomy DescriptionAn emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice4301065909MINo

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
RE065909OTHER (01)MI
H26348279MEDICARE ID-TYPE UNSPECIFIED (04)MI
P35120097MEDICARE PIN (08)MI
G92355MEDICARE UPIN (02)MI
104184200MEDICAID (05)MI
104205660MEDICAID (05)MI

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003873076 ZAKLINA DENDOOVEN CRNA
Individual
Nurse Anesthetist, Certified Registered6071 W OUTER DR
DETROIT, MI 48235
(952) 442-9770
1003877424DR. MATTHEW J GRIFFIN M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1174590384MR. DAVID CHRISTOPHER MILLER PA-C
Individual
Physician Assistant6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3250
1205836806SELECT SPECIALTY HOSPITAL - NORTHWEST DETROIT INC
Organization
Long Term Care Hospital6071 W OUTER DR 7TH FLOOR
DETROIT, MI 48235
(313) 966-4797
1346201399 BEVELY ROBERTS CRNA
Individual
Nurse Anesthetist, Certified Registered6071 W OUTER DR
DETROIT, MI 48235
(952) 442-9770
1346216744 THOMAS BAKER CRNA
Individual
Nurse Anesthetist, Certified Registered6071 W OUTER DR
DETROIT, MI 48235
(952) 442-9770
1427018225DR. MELISSA A BARTON M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1447215538GRACE UNIVERSITY MEDICAL GROUP
Organization
Internal Medicine6071 W OUTER DR DEPT OF MEDICINE 4TH FLOOR
DETROIT, MI 48235
(313) 966-4946
1447219670DR. REGINA T NOACK M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1487623617DR. MARC-ANTHONY Q VELILLA M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1497714265DR. CLAUDIA I WHITAKER M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1528022118SINAI HOSPITAL OF GREATER DETROIT
Organization
Psychiatric Unit6071 W OUTER DR
DETROIT, MI 48235
(313) 966-2026
1528037785DR. ALLISON LEVI M.D.
Individual
Emergency Medicine (Emergency Medical Services)6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1558320598DR. ANN MARIE GARRITANO M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1588623763DR. RAJAN U POPAT M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3000
1760442586DR. MARK W BRAUTIGAN M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
1780645630SINAI HOSPITAL OF GREATER DETROIT
Organization
General Acute Care Hospital6071 W OUTER DR
DETROIT, MI 48235
(313) 966-2026
1790746113DR. MARC S ROSENTHAL D.O.
Individual
Emergency Medicine6071 W OUTER DR SINAI-GRACE HOSPITAL
DETROIT, MI 48235
(313) 966-1785
1801853767SINAI HOSPITAL OF GREATER DETROIT
Organization
Rehabilitation Unit6071 W OUTER DR
DETROIT, MI 48235
(313) 966-2026
1871553404DR. HAROLD S DERSTINE M.D.
Individual
Emergency Medicine6071 W OUTER DR
DETROIT, MI 48235
(313) 966-3300
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