Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 01045234A | IN |
NPI | 1316940901 |
---|---|
Provider Name | Ross Edward Marburger |
First Address | Evansville, IN 47714-1071 |
Second Address | Evansville, IN 47714-1071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2005 |
Last Update Date | 17/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000042273 | ANTHEM BCBS (01) | IN |
0231480001 | MEDICARE DME (01) | IN |
2000096300A | (05) | IN |
G10872 | (02) | IN |