Provider Demographics
NPI:1659550903
Name:MAPILI, BRIGIDO ABOBO (RPT)
Entity Type:Individual
Prefix:
First Name:BRIGIDO
Middle Name:ABOBO
Last Name:MAPILI
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-4369
Mailing Address - Country:US
Mailing Address - Phone:866-335-3255
Mailing Address - Fax:586-601-2500
Practice Address - Street 1:4600 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-4369
Practice Address - Country:US
Practice Address - Phone:866-335-3255
Practice Address - Fax:586-601-2500
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011768208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation