Healthcare Provider Details

I. General information

NPI: 1568555423
Provider Name (Legal Business Name): MICHAEL ITALO OPIPARI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46942 HOUGHTON DR
SHELBY TOWNSHIP MI
48315-5266
US

IV. Provider business mailing address

46942 HOUGHTON DR
SHELBY TOWNSHIP MI
48315-5266
US

V. Phone/Fax

Practice location:
  • Phone: 586-726-9116
  • Fax: 586-254-8530
Mailing address:
  • Phone: 586-726-9116
  • Fax: 586-254-8530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number005375
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: