Healthcare Provider Details

I. General information

NPI: 1316520521
Provider Name (Legal Business Name): AUSTIN BELFIORI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 E 12 MILE RD
WARREN MI
48093-3472
US

IV. Provider business mailing address

11800 E 12 MILE RD
WARREN MI
48093-3472
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-5059
  • Fax: 586-694-5188
Mailing address:
  • Phone: 248-967-7425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101027934
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number02008191A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34.017683
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: