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General NPI Number Information
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NPI Number | 1487945234
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Entity Type | Individual
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Provider Name | EUGENE T ESSEGBEY
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Gender | Male
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 2506 E HILL RD
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City | GRAND BLANC
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State | MI
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Zip | 48439-5066
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Country | US
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Telephone | 810-606-1004
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Fax | 810-606-1102
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Provider Business Mailing Address
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Address Line | 2506 E HILL RD
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City | GRAND BLANC
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State | MI
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Zip | 48439-5066
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Country | US
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Telephone | 810-606-1004
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Fax | 810-606-1102
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302040269
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 015247
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License Number State | KY
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