Individual
JOHN C. EGGENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5325 ELLIOTT DR STE 104, YPSILANTI, MI 48197-8633
(734) 712-8150
(734) 712-8151
Mailing address
5325 ELLIOTT, SUITE 104, ASSOCIATES IN GENERAL AND VASCULAR SURGERY, YPSILANTI, MI 49197
(734) 712-8150
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
4301405869
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280H264470
BLUE CROSS-BLUE CROSS
—
05
—
284751010
—
MI
01
—
JE405869
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/18/2006
Last updated
07/21/2022
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