Organization Name: | ROBERT J. EGAN, M.D., PLLC |
NPI Number: | 1295133320 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT JOSEPH EGAN (MANAGER) |
Mailing Address: | 3011 W Grand Blvd Suite 2402 Detroit |
State: | MI US |
Postal Code: | 482023096 |
Phone Number: | 3135493149 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2014 |
NPI Last Update Date: | 01/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 4301074125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |