JOHN STEPHEN EBROM MD NPI 1184636953

NPI Information

  • NPI: 1184636953
  • Provider Name: JOHN STEPHEN EBROM, MD
  • Classification: Pathology - 207ZP0105X
  • Specialization: Clinical Pathology/Laboratory Medicine
  • Entity Type: Individual
  • Address: 200 JEFFERSON AVE SE
    GRAND RAPIDS, MI
    ZIP 49503
  • Phone: (616) 364-6700

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NPI Details

John Stephen Ebrom, MD is a clinical pathology/laboratory medicine pathology in Grand Rapids, MI. The provider is a pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. John Stephen Ebrom, MD NPI is 1184636953. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

200 JEFFERSON AVE SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 364-6700
Fax: (616) 364-4960

The enumeration date for this NPI number is 8/12/2006 and was last updated on 8/20/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ZP0105XPathologyClinical Pathology/Laboratory Medicine4301044412MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14525177100MEDICAIDMICHIGAN
20N73070MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
3B46573MEDICARE UPIN
4P00009267OTHERMICHIGANRR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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