Healthcare Provider Details

I. General information

NPI: 1467545970
Provider Name (Legal Business Name): MICHAEL JOHN GARNO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 WITTS END
DEERFIELD MI
49238
US

IV. Provider business mailing address

127 WITTS END
DEERFIELD MI
49238
US

V. Phone/Fax

Practice location:
  • Phone: 517-403-7003
  • Fax:
Mailing address:
  • Phone: 517-403-7003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number47-04-226451
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: