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Individual

MICHAEL A INGRAM

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1321 COLBY AVE, EVERETT, WA 98201-1665
(425) 261-2000
Mailing address
7212 151ST ST SW, EDMONDS, WA 98026-4024

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD00021544
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8318628
WA
Enumeration date
05/17/2006
Last updated
07/08/2007
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