Search › Michigan › 374J00000X
Ebonie Fairfax
NPI 1902712888 · on the registry since 2026 · sole proprietor
Practice
- Address
- 451 72nd St Se
Grand Rapids, MI 49548 - Phone
- (810) 449-0726
Registry record
- Primary taxonomy
- 374J00000X
374J00000X
- Sex
- Female
- Record last updated
- 2026-08-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan