Provider Demographics
NPI:1821848771
Name:DIGIOVANNI, SEROUR
Entity Type:Individual
Prefix:
First Name:SEROUR
Middle Name:
Last Name:DIGIOVANNI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14261 ELGIN ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1166
Mailing Address - Country:US
Mailing Address - Phone:248-797-8521
Mailing Address - Fax:
Practice Address - Street 1:14261 ELGIN ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1166
Practice Address - Country:US
Practice Address - Phone:248-797-8521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty