Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 228630 | NY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 228630 | NY |
NPI | 1417984162 |
---|---|
Provider Name | Dr. John Alan Girotto |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503-2514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 04/03/2021 |