Healthcare Provider Details

I. General information

NPI: 1902866395
Provider Name (Legal Business Name): MICHAEL ALIPIO MASINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5315 ELLIOTT DR SUITE #304
YPSILANTI MI
48197-8634
US

IV. Provider business mailing address

PO BOX 0446 24 FRANK LLOYD WRIGHT DR. LOBBY J IHA
ANN ARBOR MI
48106
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-2230
  • Fax: 734-712-2234
Mailing address:
  • Phone: 734-747-6766
  • Fax: 734-222-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number4301063094
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: