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NPI Code Detail

MEDICARE: AVRAHAM EISBRUCH MD

MEDICARE: AVRAHAM EISBRUCH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology Physician430159986MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427140821
Entity Type Code : Individual
Provider Name (Legal Business Name) : AVRAHAM EISBRUCH MD
Provider Business Mailing Address
First Line : 3621 S STATE ST
Second Line : 700 KMS PLACE
City : ANN ARBOR
State : MI
Zip : 48108
Country : US
Telephone Number : 734-936-2047
Fax Number :
Provider Business Practice Location Address
First Line : 1500 EAST MEDICAL CENTER DR
Second Line : B2 FLOOR UNIVERSITY HOSPITAL RM C490
City : ANN ARBOR
State : MI
Zip : 48109-5010
Country : US
Telephone Number : 734-936-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 03/02/2012

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