MEDICARE: DAVID EUGENE EGGERT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	4301043561	MI
2	2086S0129X	Vascular Surgery Physician	4301043561	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100913	OTHER		GREAT LAKES HEALTH PLAN
2	105036	OTHER		CARE CHOICES/PREFERRED
3	4599487	OTHER		AETNA (HEALTH PLANS)
4	0203806701	OTHER	MI	BCBS OF MI
5	1720063	OTHER	MI	PHP (HEALTH PLAN)
6	P58588	OTHER		BCN (HEALTH PLAN)
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245223874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID EUGENE EGGERT MD

Provider Business Mailing Address
First Line	:	1100 E MICHIGAN AVE
Second Line	:	SUITE 310
City	:	JACKSON
State	:	MI
Zip	:	49201-1847
Country	:	US
Telephone Number	:	517-788-6968
Fax Number	:	517-796-9122

Provider Business Practice Location Address
First Line	:	1100 E MICHIGAN AVE
Second Line	:	SUITE 310
City	:	JACKSON
State	:	MI
Zip	:	49201-1847
Country	:	US
Telephone Number	:	517-788-6968
Fax Number	:	517-796-9122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	09/11/2025

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Directions to “ DAVID EUGENE EGGERT MD” Practice Location

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