Eduardo Alberto Enriquez, P T PC
Individual provider Active NPI Physical Therapist · Milan, MI
NPI 1992907794 · NPPES record last updated Aug 18, 2010
Key facts
- NPI
- 1992907794
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5501004167 (MI)
- Practice address
- 905 Dexter St
Milan, MI 48160-1160 - Phone
- (734) 439-8410
- Fax
- (734) 439-8430
- NPI assigned
- Jun 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501004167 | MI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501004167 | MI | Yes |
Addresses
Primary practice location
905 Dexter St
Milan, MI 48160-1160
Mailing address
5778 New Meadow Dr
Ypsilanti, MI 48197-7164
Phone (734) 439-8410
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10425482410 | Medicaid | MI | |
| 383322512 | Other | MI | COMMERCIAL |
| 650D657010 | Other | MI | BLUE CROSS BLUE SHIELD |
Other providers in Milan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.