DR. JOHN DOUGLAS EBERSOLE (NPI# 1023185287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023185287 |
Entity Type | Individual |
Full Name | DR. JOHN DOUGLAS EBERSOLE |
Credential | MD |
Practice Address |
3601 W 13 Mile Rd Royal Oak MI 48073-6712 |
Mailing Address |
26901 Beaumont Blvd Ste 3d Southfield MI 48033-3849 |
Practice Telephone | 2488986064 |
Mailing Telephone | 9475221865 |
Mailing Fax Number | 9475220307 |
Enumeration Date | 2006-11-30 |
Last Update Date | 2020-10-22 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301074124 | MI | Allopathic & Osteopathic Physicians |
Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
4301074124 | MI | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
Bronson Methodist Hospital, 601 John Street, Kalamazoo, MI 49007 | 2693416411 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649535782 | John Warren Ebersole | Radiology | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1718 | 2012-07-04 |
1568487783 | John P Ebersole | Anesthesiology | 6008 Dublin Ave, Midland, MI 48640-7945 | 2006-07-12 |
1568513547 | John S Ebersole | Psychiatry & Neurology | 180 Harvester Dr Ste 110, Burr Ridge, IL 60527-6686 | 2007-01-16 |
Street Address |
3601 W 13 MILE RD |
City | ROYAL OAK |
State | MI |
Zip Code | 48073-6712 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437155538 | Cheryl A Grain | Nurse Practitioner | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2005-06-23 |
1023617735 | Kevin Wilson Curtis | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-10-22 |
1164020939 | Chelsea Cloke | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-10-14 |
1073111258 | Jaimie Danno | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-10-11 |
1447857883 | Pamela Ann Boyd | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-10-08 |
1528675618 | Riya Kaur Kalra | Pediatrics | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-09-23 |
1174139612 | Kostiantyn Romaniv | Internal Medicine | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-09-21 |
1538775325 | Adam L Hardy | Occupational Therapist | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-09-17 |
1164038964 | Patricia W Choi | Pharmacy | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-09-17 |
1598377004 | Medical Service Companies | Durable Medical Equipment & Medical Supplies | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-08-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
Find all providers in zip 48073 |
Taxonomy Code | 2085R0204X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Vascular & Interventional Radiology |
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639796386 | Vincent Shallal | Radiology | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2020-06-29 |
1467981621 | Pranav Moudgil | Radiology | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2017-06-09 |
1871930107 | Shivang Sunil Patel | Radiology | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2013-05-28 |
1952315699 | Purushottam K. Dixit | Radiology | 3601 W 13 Mile Rd, Beaumont Hospital - Ro, Royal Oak, MI 48073-6712 | 2006-07-28 |
1962449033 | Jeffrey M Wilseck | Radiology | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2006-05-31 |
1427028000 | James M Mick | Radiology | 3601 W 13 Mile Rd, Beaumont Hospital - Ro, Royal Oak, MI 48073-6712 | 2006-01-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073170221 | Mvc Clinical Practice - Mi PC | Radiology | 7125 Orchard Lake Rd Ste 120, West Bloomfield, MI 48322-3627 | 2019-05-23 |
1861905739 | Jacastillano Pllc | Radiology | 5310 Breeze Hill Pl, Troy, MI 48098-2725 | 2017-11-14 |
1366852535 | P. Adler, PC | Radiology | 26711 Woodward Ave Suite Ll1, Huntington Woods, MI 48070 | 2014-04-28 |
1245664119 | Michigan Institute for Minimally Invasive & Vascular Therapies PC | Radiology | 2370 S Linden Rd Ste 300b, Flint, MI 48532-5429 | 2013-08-28 |
1396188595 | Haiying Yu | Radiology | 1215 E Michigan Ave Fl 4, Lansing, MI 48912-1811 | 2013-04-08 |
1144549692 | Tatulya Tiwari | Radiology | 1500 E. Medical Center Dr #b1f510k, Rad: Diagnostic Radiology, Ann Arbor, MI 48109-5030 | 2010-05-24 |
1811164437 | Faiz D Francis | Radiology | 903 Wesley Dr, Troy, MI 48098-5622 | 2008-05-13 |
1851411227 | Chutcharn Kongphanich | Radiology | 1044 Island Drive Ct Apt 104, Ann Arbor, MI 48105-2075 | 2007-03-30 |
1629146527 | Advanced Diagnostic Imaging Interventional & Vascular Center | Radiology | 5462 State St, Saginaw, MI 48603-3678 | 2006-12-01 |
1780630541 | Michael E Lulenski | Radiology | 22731 Newman St Ste 250, Dearborn, MI 48124-1930 | 2006-05-25 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on DR. JOHN DOUGLAS EBERSOLE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.