Provider Demographics
NPI:1750376745
Name:GIANNINI, DENNIS STEVEN (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:STEVEN
Last Name:GIANNINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 E WATTLES RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5099
Mailing Address - Country:US
Mailing Address - Phone:248-528-0050
Mailing Address - Fax:248-528-0909
Practice Address - Street 1:1950 E WATTLES RD
Practice Address - Street 2:SUITE 110
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-5099
Practice Address - Country:US
Practice Address - Phone:248-528-0050
Practice Address - Fax:248-528-0909
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301406072208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2506346372OtherBCBS OF MICHIGAN
MI2506346372OtherBCBS OF MICHIGAN
MIE16193Medicare UPIN