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General NPI Number Information
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NPI Number | 1073844841
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Entity Type | Organization
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Legal Business Name | EDWARD J NEBEL, M.D. PC
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 2615 ELECTRIC AVE SUITE A
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City | PORT HURON
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State | MI
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Zip | 48060-6575
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Country | US
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Telephone | 810-982-9911
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Fax | 810-985-7740
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Provider Business Mailing Address
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Address Line | 2615 ELECTRIC AVE SUITE A
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City | PORT HURON
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State | MI
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Zip | 48060-6575
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Country | US
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Telephone | 810-982-9911
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Fax | 810-985-7740
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD J NEBEL
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Credential | M.D.
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Telephone | 810-982-9911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | EN027615
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License Number State | MI
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