1053376202 NPI number — SIGITA ALIMENTI M.D.

Table of content: SIGITA ALIMENTI M.D. (NPI 1053376202)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053376202 NPI number — SIGITA ALIMENTI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALIMENTI
Provider First Name:
SIGITA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053376202
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
405 MOMANY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT JOSEPH
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49085-2178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-982-2099
Provider Business Mailing Address Fax Number:
269-982-1950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
405 MOMANY DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST JOSEPH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49085-2178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-982-2099
Provider Business Practice Location Address Fax Number:
269-982-1950
Provider Enumeration Date:
04/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  4301080747 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 700A110160 . This is a "CMC BCBS GROUP ID #" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 151173 . This is a "GLHP PIN #" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: SA080747 . This is a "BCBS PROVIDER ID #" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1053376202 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104769332 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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