Healthcare Provider Details
I. General information
NPI: 1972776052
Provider Name (Legal Business Name): MEHMET C AGABIGUM MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/09/2008
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5040 VILLA LINDE PKWY STE A
FLINT MI
48532-3445
US
IV. Provider business mailing address
5040 VILLA LINDE PKWY STE A
FLINT MI
48532-3445
US
V. Phone/Fax
- Phone: 810-732-4250
- Fax: 810-732-0444
- Phone: 810-732-4250
- Fax: 810-732-0444
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YX0905X |
| Taxonomy | Otolaryngology/Facial Plastic Surgery Physician |
| License Number | 4301040397 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
MEHMET
C
AGABIGUM
Title or Position: PRESIDENT
Credential: M.D
Phone: 810-732-4250