Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 5901001986 | MI |
NPI | 1245242320 |
---|---|
Provider Name | Dr. Edward Paul Abegg |
First Address | Richland, MI 49083-8613 |
Second Address | Southfield, MI 48034-2184 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/07/2007 |