Provider Demographics
NPI:1730120361
Name:TRUPIANO, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:TRUPIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 W BIG BEAVER RD STE 1130
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-5298
Mailing Address - Country:US
Mailing Address - Phone:248-220-3310
Mailing Address - Fax:248-220-3311
Practice Address - Street 1:201 W BIG BEAVER RD STE 1140
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4160
Practice Address - Country:US
Practice Address - Phone:248-220-3310
Practice Address - Fax:248-220-3311
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081182207XS0106X, 208200000X, 2082S0105X, 2086S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301081182OtherMICHIGAN MEDICAL LICENSE
MI2406359742OtherBCBS PROVIDER NUMBER
MI11535104OtherCAQH
MIJT081182OtherSTATE BLUE CROSS
MI0P44100001Medicare PIN
MI11535104OtherCAQH
MI2406359742OtherBCBS PROVIDER NUMBER