Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD25525 | OR |
Y | 208600000X | Surgeon | MD25525 | OR |
N | 2086S0102X | Surgical Critical Care | MD25525 | OR |
NPI | 1285677088 |
---|---|
Provider Name | Dr. Michael C. Egan |
First Address | Lincoln City, OR 97367-4524 |
Second Address | Lincoln City, OR 97367-4524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 08/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C36839 | (02) | OR |