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Contact Information

BLAISE EBY, PA-C
2799 W GRAND BLVD
DETROIT, MI48202-2608
 Phone: 800-653-6568
 Fax: 313-876-1305
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for BLAISE EBY · (Male)

NPI # 1114599230
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/16/2021
Last updated 03/17/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5601011612
Hospital affiliation(s)
  • MEMORIAL HOSPITAL AND HEALTH CARE CENTER - (Acute Care)
    800 W 9TH ST
    JASPER, IN 47546
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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