Healthcare Provider Details

I. General information

NPI: 1851589584
Provider Name (Legal Business Name): LOUIS L RONDINI DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

27500 HOOVER RD SUITE 100
WARREN MI
48093-4586
US

IV. Provider business mailing address

27500 HOOVER RD SUITE 100
WARREN MI
48093-4586
US

V. Phone/Fax

Practice location:
  • Phone: 586-754-2558
  • Fax: 586-759-7791
Mailing address:
  • Phone: 586-754-2558
  • Fax: 586-759-7791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: LOUIS L RONDINI
Title or Position: OWNER
Credential: DO
Phone: 586-754-2558