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General NPI Number Information
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NPI Number | 1417189549
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Entity Type | Individual
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Provider Name | MICHAEL GINSBURG MD
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Gender | Male
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 100 NAVARRE PL STE 5500
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City | SOUTH BEND
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State | IN
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Zip | 46601-1172
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Country | US
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Telephone | 574-647-5200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 220
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City | MCHENRY
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State | IL
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Zip | 60051-0220
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Country | US
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Telephone | 815-759-0800
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Fax | 815-759-2367
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 71181-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036.130514
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036130514
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME139489
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 01089216A
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License Number State | IN
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