Provider Demographics
NPI:1710409651
Name:PINTO, EDUARDO MARTIN (RPH)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:MARTIN
Last Name:PINTO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3811 COOLIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1466
Mailing Address - Country:US
Mailing Address - Phone:248-797-9756
Mailing Address - Fax:
Practice Address - Street 1:3811 COOLIDGE HWY
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084
Practice Address - Country:US
Practice Address - Phone:248-797-9756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037518183500000X, 1835G0303X, 1835P1200X, 1835P2201X, 1835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition SupportGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Single Specialty