Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eastlake Medical Center

Organization Geriatric Medicine (Family Medicine) Physician · NPI 1821267832

Eastlake Medical Center is a Geriatric Medicine (Family Medicine) Physician in Detroit, Michigan. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
2

Practice location Address checks out

646 Chene St
Detroit, MI 48207-3979
Phone: (248) 747-3425
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Geriatric Medicine (Family Medicine) Physician Taxonomy 207QG0300X

Record details

NPI number1821267832
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bianca Dooley — President Ceo · (248) 747-3425
NPI enumeratedFebruary 23, 2008
Last updated in NPPESFebruary 23, 2008
Mailing address17520 W 12 Mile Rd Ste 116, Southfield, MI 48076-1907

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