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Individual

DR. JONATHAN A AGBEBIYI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD.,CMHT.,MBA.

Contact information

Practice address
20755 GREENFIELD RD, SUITE 100, SOUTHFIELD, MI 48075
(248) 436-1959
(248) 436-1978
Mailing address
22200 W 11 MILE RD # 3455, SOUTHFIELD, MI 48037-9991
(248) 436-1959
(248) 436-1978

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301041053
MI
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
4301041053
MI

Other

Enumeration date
11/09/2006
Last updated
04/13/2012
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