Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 35076208 | OH |
NPI | 1215096748 |
---|---|
Provider Name | Dr. Daniel M Ebert |
First Address | Poland, OH 44514-3252 |
Second Address | Poland, OH 44514-3252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 14/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2236931 | (05) | OH |
H33253 | (02) |