Provider Demographics
NPI:1972776052
Name:MEHMET C AGABIGUM MD PC
Entity Type:Organization
Organization Name:MEHMET C AGABIGUM MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHMET
Authorized Official - Middle Name:C
Authorized Official - Last Name:AGABIGUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-732-4250
Mailing Address - Street 1:5040 VILLA LINDE PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3445
Mailing Address - Country:US
Mailing Address - Phone:810-732-4250
Mailing Address - Fax:810-732-0444
Practice Address - Street 1:5040 VILLA LINDE PKWY
Practice Address - Street 2:STE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3445
Practice Address - Country:US
Practice Address - Phone:810-732-4250
Practice Address - Fax:810-732-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301040397207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0402500732OtherBLUE CROSS BLUE SHIELD
MI0400732OtherHEALTH PLUS
MI2115367Medicaid
MI0400732OtherHEALTH PLUS
MI0250073Medicare PIN