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Individual

DR. PAUL HERBERT IZENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5333 MCAULEY DR, SUITE R5001, YPSILANTI, MI 48197-1014
(734) 712-2323
(734) 712-2312
Mailing address
5333 MCAULEY DRIVE, SUITE R5001, YPSILANTI, MI 48197
(734) 712-2323
(734) 712-2312

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301037154
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102225
CARE CHOICES HMO
MI
01
6976
CAPE
MI
01
B43925
HEALTH ALLIANCE PLAN
MI
01
P41548
BLUE CARE NETWORK
MI
Enumeration date
07/24/2006
Last updated
07/08/2007
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