Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301064025 | MI |
NPI | 1033228903 |
---|---|
Provider Name | Mark C Pinto |
First Address | Ann Arbor, MI 48106 |
Second Address | Chelsea, MI 48118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 19/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0H11016 | BCBSM GROUP PIN (01) | MI |
G55926 | (02) | MI |