{
"Npi": {
"NPI": "1285985309",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROLANDO M. ESTUPIGAN D.O. P.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2265 LIVERNOIS",
"SecondLineMailingAddress": "STE 402",
"MailingAddressCityName": "TROY",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48083-1606",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-649-2430",
"MailingAddressFaxNumber": "248-649-4303",
"FirstLinePracticeLocationAddress": "2265 LIVERNOIS RD STE 402",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TROY",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48083-1606",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-649-2430",
"PracticeLocationAddressFaxNumber": "248-649-4303",
"EnumerationDate": "09/28/2012",
"LastUpdateDate": "07/10/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ESTUPIGAN",
"AuthorizedOfficialFirstName": "ROLANDO",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.O",
"AuthorizedOfficialTelephoneNumber": "248-649-2430",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "5101010979",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}