Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 10179 | SC |
NPI | 1215900766 |
---|---|
Provider Name | Dr. Michael Parrino |
First Address | Seneca, SC 29679-0947 |
Second Address | Deming, NM 88030-4037 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 07/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101794 | (05) | SC |
GP1060 | (05) | SC |
RHC100 | (05) | SC |