Evan Bradley Fonger, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301087817 Issued in MI

Practice address

400 Mack Avenue
Detroit, MI 48201

Phone

(313) 578-5000

Fax

(313) 578-6379

NPI assigned

Jun 6, 2007

Last updated

Oct 9, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mymichigan Medical Group

  • Family Medicine Physician
  • Midland, MI
  • NPI 1740230127
  Medicare reassignment NPD
• Wings of Hope Hospice and Palliative Care Inc.

  dba Journeys Advanced Illness Management

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Allegan, MI
  • NPI 1306249073
  Medicare reassignment NPD
• Mymichigan Medical Center Alpena

  dba MyMichigan Family Medicine

  • Rural Health Clinic/Center
  • Alpena, MI
  • NPI 1144722604

  Hospice and Palliative Medicine

  NPD
• Wings of Hope Hospice and Palliative Care, Inc.

  • Community Based Hospice Care Agency
  • Allegan, MI
  • NPI 1609871425

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1467655886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136",
            "telephone_number": "313-578-5000",
            "fax_number": "313-578-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MACK AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-578-5000",
            "fax_number": "313-578-6379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2366 Oak Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481038944",
            "country_code": "US",
            "telephone_number": "888-247-5701",
            "fax_number": "888-466-7578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONGER",
        "first_name": "EVAN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301087817",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MI",
            "license": "4301087817",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Evan.Fonger@HOM.ORG",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2366 Oak Valley Dr",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481038944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kiyana Shanae Folks
• Michele Puente Follebout, LMSW
• Jason Robert Folt, M.D.
• Isabel Foltz
• Preston L Fong
• Nancy Fonkoua Bogne
• Xavier Fonseca Fuentes
• Alayna Nettie Fonseca
• Esperanza Enid Font-Montgomery, M.D.
• Fontaine Housing LLC

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.