Provider Demographics
NPI:1043530215
Name:BIONDO-SAVIN, ERIC JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOSEPH
Last Name:BIONDO-SAVIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD
Mailing Address - Street 2:A201
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:804 SERVICE RD
Practice Address - Street 2:D100
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7015
Practice Address - Country:US
Practice Address - Phone:517-353-5053
Practice Address - Fax:517-432-4394
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51010166282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1043530215Medicaid
MI0C36350106Medicare PIN