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Individual

MATTHEW WILLIAM EBINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
1 FORD PL STE 2E, DETROIT, MI 48202-3450
(313) 874-4806

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101013506
MI
207RC0000X
Cardiovascular Disease Physician
5101013506
MI
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
5101013506
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11
11
MI
05
PENDING
MI
Enumeration date
05/06/2006
Last updated
10/05/2022
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