Provider Demographics
NPI:1073565578
Name:PERRI, GIOVANNINO ANTONIS (MD)
Entity Type:Individual
Prefix:
First Name:GIOVANNINO
Middle Name:ANTONIS
Last Name:PERRI
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 1:400 S PINE ST
Mailing Address - Street 2:P. O. BOX 30479
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48933-2250
Mailing Address - Country:US
Mailing Address - Phone:517-335-5189
Mailing Address - Fax:517-241-8135
Practice Address - Street 1:400 S PINE ST
Practice Address - Street 2:SIXTH FLOOR
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48933-2250
Practice Address - Country:US
Practice Address - Phone:517-335-5189
Practice Address - Fax:517-241-8135
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010337472083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine