Healthcare Provider Details

I. General information

NPI: 1538147723
Provider Name (Legal Business Name): FRANK PATINO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 10/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29150 BUCKINGHAM, SUITE #6
LIVONIA MI
48154
US

IV. Provider business mailing address

29150 BUCKINGHAM, SUITE #6
LIVONIA MI
48154
US

V. Phone/Fax

Practice location:
  • Phone: 734-834-1944
  • Fax: 734-459-7455
Mailing address:
  • Phone: 734-834-1944
  • Fax: 734-459-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number4301051672
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301051672
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301051672
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number4301051672
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301051672
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: