Provider Demographics
NPI:1982691739
Name:ADELSON, HOWARD BLAKE (DO)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:BLAKE
Last Name:ADELSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:40053 8 MILE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1954
Mailing Address - Country:US
Mailing Address - Phone:248-449-9292
Mailing Address - Fax:248-449-1081
Practice Address - Street 1:40053 8 MILE RD STE 100
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1954
Practice Address - Country:US
Practice Address - Phone:248-449-9292
Practice Address - Fax:248-449-1081
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2024-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013626207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH33458OtherHEALTH ALLIANCE PLAN
MI200101126OtherUNITED HEALTH CARE
MI134091OtherCARE CHOICES
MI9330860OtherCIGNA HEALTH CARE
MI4535674Medicaid
MI16316OtherMCARE
MIP00157791OtherMEDICARE RAILROAD
MI1858211224OtherBLUE CROSS BLUE SHIELD MI
MI200101126OtherPPOM