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NPI Code Detail

MEDICARE: DR. MARIO ROBERTO LANNI M.D.

MEDICARE:  DR. MARIO ROBERTO LANNI  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
12084P0800XPsychiatry Physician4301078394MI

General Provider Information

NPI Number : 1609820737
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIO ROBERTO LANNI M.D.
Provider Business Mailing Address
First Line : 1501 KRAFFT RD
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3565
Country : US
Telephone Number : 810-985-5125
Fax Number : 810-985-5127
Provider Business Practice Location Address
First Line : 1501 KRAFFT RD
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3565
Country : US
Telephone Number : 810-985-5125
Fax Number : 810-985-5127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MARIO ROBERTO LANNI M.D.” Practice Location

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