NPI 1255508487

Edwin Robert Itenberg, DO

Practitioner Colon & Rectal Surgery Physician Southfield, MI

Practice location

Address: 16001 W 9 Mile Rd Fisher Building 3rd Floor, Southfield, MI 48075-4818
Phone: (248) 849-6030
Fax: (248) 849-6039

Registered specialties (2)

Colon & Rectal Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208C00000X Licence 5101019112 (MI)

Other Colon & Rectal Surgery providers in Michigan →

Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 5101019112 (MI)

Other Surgery providers in Michigan →

Registry record

NPI: 1255508487
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 May 2008
Record last updated: 5 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.