Ebert Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101009029 Issued in MI

Legal business name

EBERT MEDICAL PC

Practice address

6800 Newark Rd
Ste 300
Imlay City, MI 48444-9656

Phone

(810) 724-1600

Fax

(810) 724-1603

NPI assigned

Jan 23, 2007

Last updated

Nov 29, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Galen Ebert, DO

Title

Owner

Phone

(810) 424-2007

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1639223910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 NEWARK RD",
            "address_2": "STE 300",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484449656",
            "telephone_number": "810-724-1600",
            "fax_number": "810-724-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 NEWARK RD",
            "address_2": "STE 300",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484449656",
            "telephone_number": "810-724-1600",
            "fax_number": "810-724-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBERT MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "GALEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-424-2007",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Imlay City, MI
• Providers in Imlay City, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.