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General NPI Number Information
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NPI Number | 1972670263
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Entity Type | Individual
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Provider Name | MICHELANGELO SCAFIDI CERTIFIED PEDORTHIST
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 8344 W LAWRENCE AVE
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City | NORRIDGE
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State | IL
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Zip | 60706-3152
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Country | US
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Telephone | 708-453-4900
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Fax | 708-453-3338
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Provider Business Mailing Address
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Address Line | 8344 W LAWRENCE AVE
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City | NORRIDGE
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State | IL
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Zip | 60706-3152
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Country | US
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Telephone | 708-453-4900
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Fax | 708-453-3338
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 332BC3200X
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License Number State | IL
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