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Individual
JAMES ROBERT EBBEN
Active
Individual
JAMES ROBERT EBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29793
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29793
LICENSE
WI
01
—
354601
AMERICAN BOARD OF FAMILY MEDICINE-SPORTS MEDICINE
—
Enumeration date
12/08/2005
Last updated
05/18/2021
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