Individual
MR. JOHN P EGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1675 LEAHY ST, STE 324B, MUSKEGON, MI 49442-5500
(231) 726-5075
(231) 722-1827
Mailing address
PO BOX 1847, MUSKEGON, MI 49443-1847
(231) 727-4444
(231) 727-4451
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301048705
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2803005
—
MI
01
—
MI1763
MEDICARE GROUP PTAN
MI
Enumeration date
10/31/2005
Last updated
02/19/2014
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