Provider Demographics
NPI:1952384661
Name:COGO, GIULIO JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:GIULIO
Middle Name:JAMES
Last Name:COGO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5889 WHITMORE LAKE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1998
Mailing Address - Country:US
Mailing Address - Phone:810-227-7799
Mailing Address - Fax:810-227-8999
Practice Address - Street 1:5889 WHITMORE LAKE RD
Practice Address - Street 2:SUITE C
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1998
Practice Address - Country:US
Practice Address - Phone:810-227-7799
Practice Address - Fax:810-227-8999
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGC002816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI144459151Medicaid
MI0D71111OtherBCBSM
MIT33099Medicare UPIN
MI0D71111OtherBCBSM