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NPI Code Detail

MEDICARE: PAOLO E. DI LIDDO D.P.M.

MEDICARE: PAOLO E. DI LIDDO D.P.M.
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
1213E00000XPodiatrist5901001902MI
2213ES0103XFoot & Ankle Surgery Podiatrist5901001902MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1480H280180OTHERBLUE CROSS-BLUE CROSS
2PD001902OTHERCOMMERCIAL-COMMERCIAL NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4PD001902OTHERCHAMPUS-CHAMPUS

General Provider Information

NPI Number : 1386657088
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAOLO E. DI LIDDO D.P.M.
Provider Business Mailing Address
First Line : 14500 HALL RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48313-1229
Country : US
Telephone Number : 586-247-3764
Fax Number : 586-247-2673
Provider Business Practice Location Address
First Line : 14500 HALL RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48313-1229
Country : US
Telephone Number : 586-247-3764
Fax Number : 586-247-2673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2006
Last Update Date : 11/07/2023

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