Provider Demographics
NPI:1033180161
Name:FINAZZO, SALVATORE JOHN (DO)
Entity type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:JOHN
Last Name:FINAZZO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1651 KINGSWAY CT
Mailing Address - Street 2:STE A
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183
Mailing Address - Country:US
Mailing Address - Phone:734-671-2110
Mailing Address - Fax:734-671-5344
Practice Address - Street 1:1651 KINGSWAY CT
Practice Address - Street 2:STE. A
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183
Practice Address - Country:US
Practice Address - Phone:734-671-2110
Practice Address - Fax:734-671-5344
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI510417353207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4469720Medicaid
MIQ24657028Medicare PIN
MI4469720Medicaid
MION81520Medicare PIN