Provider Demographics
NPI:1003813668
Name:BULINSKI, PATRICK P (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:P
Last Name:BULINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 W. FAIR AVENUE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2675
Mailing Address - Country:US
Mailing Address - Phone:906-225-3853
Mailing Address - Fax:906-228-4065
Practice Address - Street 1:1414 W. FAIR AVENUE
Practice Address - Street 2:SUITE 230
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2675
Practice Address - Country:US
Practice Address - Phone:906-225-3853
Practice Address - Fax:906-228-4065
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPB064047208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4117101Medicaid
MI4227101Medicaid
MI0E26017OtherBLUE CROSS/BLUE SHIELD
MI4117101Medicaid
020E26017006Medicare PIN
MIH16469Medicare UPIN
MI4227101Medicaid