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NPI Code Detail

MEDICARE: ANTHONY L ALCANTARA M.D.

MEDICARE: ANTHONY L ALCANTARA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician4301054515MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10H26188032OTHERFED BLACK LUNG PROGRAM
20Q26008OTHERMIBCBS PROVIDER NUMBER
30Q26008055OTHERFREDERAL BLACK LUNG
41006439OTHERMIMCLAREN HEALTH
5143536OTHERMIGREAT LAKES HEALTH
6P00063034OTHERPALMETTO GBA RAILROAD MED
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8455311710OTHERMIPRO CARE

General Provider Information

NPI Number : 1194720532
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY L ALCANTARA M.D.
Provider Business Mailing Address
First Line : 36175 HARPER AVE
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48035-3274
Country : US
Telephone Number : 586-741-3772
Fax Number : 586-741-4604
Provider Business Practice Location Address
First Line : 36175 HARPER AVE
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48035-3274
Country : US
Telephone Number : 586-741-3772
Fax Number : 586-741-4604
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 03/14/2011

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