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General NPI Number Information
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NPI Number | 1285679589
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Entity Type | Individual
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Provider Name | JOHN D SERINI DO
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Gender | Male
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 05/09/2017
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Provider Practice Location Address
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Address Line | 2093 HEALTH DR SW SUITE 101
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City | WYOMING
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State | MI
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Zip | 49519-9691
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Country | US
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Telephone | 616-828-5727
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Fax | 616-828-5726
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Provider Business Mailing Address
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Address Line | 2093 HEALTH DR SW SUITE 101
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City | WYOMING
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State | MI
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Zip | 49519-9691
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Country | US
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Telephone | 616-828-5727
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Fax | 616-828-5726
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 5101007294
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License Number State | MI
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