Individual
JOHN R. EBRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
726 S RENAUD RD, GROSSE POINTE WOODS, MI 48236-1799
(313) 882-2468
Mailing address
726 S RENAUD RD, GROSSE POINTE WOODS, MI 48236-1799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301037528
MI
207RI0200X
Infectious Disease Physician
Primary
4301037528
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440Q263940
BLUE CROSS-BLUE CROSS
—
05
—
447487310
—
MI
01
—
JE037528
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
06/01/2006
Last updated
08/11/2022
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