Provider Demographics
NPI:1568555423
Name:OPIPARI, MICHAEL ITALO (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ITALO
Last Name:OPIPARI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:46942 HOUGHTON DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-5266
Mailing Address - Country:US
Mailing Address - Phone:586-726-9116
Mailing Address - Fax:586-254-8530
Practice Address - Street 1:46942 HOUGHTON DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-5266
Practice Address - Country:US
Practice Address - Phone:586-726-9116
Practice Address - Fax:586-254-8530
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI005375207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1209979Medicaid
MI1209979Medicaid