Provider Demographics
NPI:1356311963
Name:SITTO, EMIL S (MD)
Entity Type:Individual
Prefix:DR
First Name:EMIL
Middle Name:S
Last Name:SITTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37538 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-3511
Mailing Address - Country:US
Mailing Address - Phone:586-939-3073
Mailing Address - Fax:586-939-4314
Practice Address - Street 1:37538 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-3511
Practice Address - Country:US
Practice Address - Phone:586-939-3073
Practice Address - Fax:586-939-4314
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301040629207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1356311963Medicaid
MI700E012740OtherBCBSM GROUP PIN
MIF01922Medicare UPIN
MI1356311963Medicaid