| Rolando M. Estupigan D.o. P.c. | |
|
2265 Livernois Rd Ste 402 Troy MI 48083-1606 | |
| (248) 649-2430 | |
| (248) 649-4303 |
| Full Name | Rolando M. Estupigan D.o. P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2265 Livernois Rd Ste 402, Troy, Michigan |
| Authorized Official Name and Position | Rolando M. Estupigan (PRESIDENT) |
| Authorized Official Contact | 2486492430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rolando M. Estupigan D.o. P.c. 2265 Livernois Ste 402 Troy MI 48083-1606 Ph: (248) 649-2430 | Rolando M. Estupigan D.o. P.c. 2265 Livernois Rd Ste 402 Troy MI 48083-1606 Ph: (248) 649-2430 |
| NPI Number | 1285985309 |
|---|---|
| Provider Enumeration Date | 09/28/2012 |
| Last Update Date | 07/10/2020 |
| Medicare PECOS PAC ID | 3577713171 |
|---|---|
| Medicare Enrollment ID | O20121017000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285985309 | NPI | - | NPPES |
| 3370408 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 5101010979 (Michigan) | Primary |
| Provider Name | Rolando M Estupigan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841208592 PECOS PAC ID: 1658521265 Enrollment ID: I20121017000083 |
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