Provider Demographics
NPI:1538147723
Name:PATINO, FRANK (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:PATINO
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 1:29150 BUCKINGHAM, SUITE #6
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154
Mailing Address - Country:US
Mailing Address - Phone:734-834-1944
Mailing Address - Fax:734-459-7455
Practice Address - Street 1:29150 BUCKINGHAM, SUITE #6
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154
Practice Address - Country:US
Practice Address - Phone:734-834-1944
Practice Address - Fax:734-459-7455
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301051672202C00000X, 207PE0004X, 207R00000X, 207RS0010X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1108249881OtherBCBS
MIF39652Medicare UPIN
MI1108249881OtherBCBS
MIQ26294292Medicare ID - Type UnspecifiedPEC OKW