MEDICARE: DR. EMIL S. SITTO 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
1	207R00000X	Internal Medicine Physician	4301040629	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	700E012740	OTHER	MI	BCBSM GROUP PIN

General Provider Information

NPI Number	:	1356311963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMIL S. SITTO M.D.

Provider Business Mailing Address
First Line	:	37538 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-3511
Country	:	US
Telephone Number	:	586-939-3073
Fax Number	:	586-939-4314

Provider Business Practice Location Address
First Line	:	37538 DEQUINDRE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-3511
Country	:	US
Telephone Number	:	586-939-3073
Fax Number	:	586-939-4314

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	04/14/2015

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