Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Edwin Robert Itenberg, DO

Individual provider Colon & Rectal Surgery Physician · NPI 1255508487

Dr. Edwin Robert Itenberg, DO is a Colorectal Surgery (Proctology) in Southfield, Michigan. Graduated from New York College of Osteo Medicine of New York Institute of Technology in 2006, 20 years ago. Practices with Henry Ford Health System, a 2,540-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
20
Trained at
New York College of Osteo Medicine of New York Institute of Technology
Licensed in
MI
In the registry since
2008
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

16001 W 9 Mile Rd Fisher Bldg 3RD Fl
Southfield, MI 48075-4818
Phone: (248) 849-6030
Fax: (248) 849-6039
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Colon & Rectal Surgery Physician (primary) Taxonomy 208C00000X · Licence 5101019112 (MI)
Surgery Physician Taxonomy 208600000X · Licence 5101019112 (MI)

Record details

NPI number1255508487
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMay 16, 2008
Last updated in NPPESDecember 5, 2012
Mailing address16001 W 9 Mile Rd, Fisher Building 3rd Floor, Southfield, MI 48075-4818

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCOLORECTAL SURGERY (PROCTOLOGY)
Also practisesGENERAL SURGERY
Medical schoolNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated 2006 (20 years in practice)
Group practice Henry Ford Health System — 2540 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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