Provider Demographics
NPI:1245340975
Name:FILIPOF, NATALIA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:FILIPOF
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 1:581 BALLANTYNE RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2635
Mailing Address - Country:US
Mailing Address - Phone:586-945-1652
Mailing Address - Fax:
Practice Address - Street 1:20030 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-2323
Practice Address - Country:US
Practice Address - Phone:313-884-3380
Practice Address - Fax:313-884-9756
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301063501OtherSTATE LICENSE
G82344Medicare UPIN