Healthcare Provider Details

I. General information

NPI: 1437573177
Provider Name (Legal Business Name): MICHAEL D PIZZIMENTI DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 02/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23211 N 21 MILE ROAD
MACOMB MI
48042
US

IV. Provider business mailing address

1773 STAR BATT DR
ROCHESTER HILLS MI
48309-3708
US

V. Phone/Fax

Practice location:
  • Phone: 586-231-0043
  • Fax: 586-741-8953
Mailing address:
  • Phone: 248-601-9207
  • Fax: 248-650-8670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501016668
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: