Individual
EMIL ETHAN EBNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085
(269) 983-8300
(269) 985-4523
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 982-4862
(269) 985-4535
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101020015
MI
208000000X
Pediatrics Physician
Primary
5101020015
MI
208M00000X
Hospitalist Physician
5101020015
MI
Other
Enumeration date
06/01/2012
Last updated
07/16/2018
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