Individual
MICHAEL R. EBERHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
70 MEDICAL CENTER DR, COMMERCE, GA 30529-1078
(706) 335-1102
(706) 336-8419
Mailing address
861 SW 78TH AVE, SUITE # 100B, PLANTATION, FL 33324-3273
(954) 693-0000
(954) 693-0005
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
021452
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000230557R
—
GA
01
—
52024750-004
BCBS
GA
Enumeration date
11/17/2006
Last updated
07/08/2007
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