EBONI EDWARDS – NPI #1245188168
Clinic/Center

EBONI EDWARDS is an AHC clinic located in DEARBORN, MI. NPPES recently assigned the NPI number 1245188168 to EBONI EDWARDS on March 17, 2026. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 261QH0100X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Health Service

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EBONI EDWARDS below.

NPI Profile for
EBONI EDWARDS

NPI Number
1245188168
Enumeration Date

(about 3 months ago)
Entity Type
Type-1  Individual (Male)
Legal Name
EBONI EDWARDS
Primary location
6425 SCHAEFER RD
DEARBORN, MI 48126-1974
Phone: (313) 552-6630 Fax:
Mailing address
3612 MILDRED ST
WAYNE, MI 48184-1909
Phone: Fax:
Sole Proprietor
Yes
Updated
Certification Date
Mar 17, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QH0100X
- Clinic/Center / Health Service (Primary)
MI

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.