Healthcare Provider Details

I. General information

NPI: 1174502249
Provider Name (Legal Business Name): EFRAIM GELBARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E SHERMAN BLVD
MUSKEGON MI
49444-1849
US

IV. Provider business mailing address

550 W WESTERN AVE SUITE B
MUSKEGON MI
49440-1045
US

V. Phone/Fax

Practice location:
  • Phone: 231-672-2000
  • Fax:
Mailing address:
  • Phone: 231-726-4498
  • Fax: 231-726-4468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301077066
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: