Ettel, George L.

Ettel, George L. is an individual health care provider with primary practice located at 8950 Dr Martin Luther King St N Suite 180, St Petersburg FL 33702-3001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ettel, George L. can be contacted via phone (727) 576-8900.

Contact Information

Primary practice address
8950 Dr Martin Luther King St N Suite 180 St Petersburg FL 33702-3001
Phone: (727) 576-8900
Fax: (727) 570-9045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME44450 Florida

Profile Details

NPI number 1619962636
LBN Legal business name Ettel, George L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2005
Last updated Jul 15th, 2011 - about 14 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 1619962636 NPPES
Florida MEDICAID 040585000

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