Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4351044689 | MI |
Y | 111NI0900X | Internist | 4351044689 | MI |
NPI | 1003377862 |
---|---|
Provider Name | Dr. James Paolo Purtell |
First Address | Detroit, MI 48202-2689 |
Second Address | Detroit, MI 48202-2689 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2019 |
Last Update Date | 19/01/2022 |