Provider Demographics
NPI:1043392707
Name:JOHN M. TRUPIANO, MD, PC
Entity Type:Organization
Organization Name:JOHN M. TRUPIANO, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TRUPIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-206-9730
Mailing Address - Street 1:201 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 1130
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4152
Mailing Address - Country:US
Mailing Address - Phone:586-206-9730
Mailing Address - Fax:248-524-0934
Practice Address - Street 1:201 W BIG BEAVER RD
Practice Address - Street 2:SUITE 1130
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4152
Practice Address - Country:US
Practice Address - Phone:586-206-9730
Practice Address - Fax:248-524-0934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081182208200000X, 2082S0105X, 2086S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11535104OtherCAQH
MI2406359742OtherBCBS PROVIDER NUMBER
MIJT081182OtherSTATE BLUE CROSS
MI4301081182OtherMICHIGAN MEDICAL LICENSE
MII49384Medicare UPIN
MI2406359742OtherBCBS PROVIDER NUMBER