Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 4301081182 | MI |
N | 208200000X | Surgeon | 4301081182 | MI |
N | 208600000X | Surgeon | 4301081182 | MI |
N | 2082S0105X | Plastic Hand Surgeon | 4301081182 | MI |
N | 2086S0105X | Surgery of the Hand | 4301081182 | MI |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 4301081182 | MI |
NPI | 1730120361 |
---|---|
Provider Name | Dr. John Michael Trupiano |
First Address | Troy, MI 48084-5298 |
Second Address | Troy, MI 48084-4160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 16/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11535104 | CAQH (01) | MI |
2406359742 | BCBS PROVIDER NUMBER (01) | MI |
4301081182 | MICHIGAN MEDICAL LICENSE (01) | MI |
I49384 | (02) | MI |
JT081182 | STATE BLUE CROSS (01) | MI |