Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 4301040397 | MI |
NPI | 1740265362 |
---|---|
Provider Name | Mr. Mehmet Cemal Agabigum |
First Address | Flint, MI 48532-3445 |
Second Address | Flint, MI 48532-3445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 15/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0400732 | HEALTH PLUS (01) | MI |
0402500732 | BLUE CROSS BLUE SHIELD (01) | MI |
2115367 | (05) | MI |
B47657 | (02) |