Ebertz, Michael John

Ebertz, Michael John is an individual health care provider with primary practice located at 14000 Nicollet Ave Suite 304, Burnsville MN 55337-5790. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Ebertz, Michael John can be contacted via phone (952) 898-1600.

Contact Information

Primary practice address
14000 Nicollet Ave Suite 304 Burnsville MN 55337-5790
Phone: (952) 898-1600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 36998 Minnesota
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 36998 Minnesota

Profile Details

NPI number 1144386392
LBN Legal business name Ebertz, Michael John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Oct 15th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144386392 NPPES
Minnesota MEDICAID 225522700

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