Boccaccio, John Elliott
Boccaccio, John Elliott is an individual health care provider with primary practice located at 19229 Mack Ave Suite 38, Grosse Pointe Woods MI 48236-2858. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Boccaccio, John Elliott can be contacted via phone (313) 885-1520.Contact Information
Primary practice address
19229 Mack Ave Suite 38
Grosse Pointe Woods MI 48236-2858
Phone: (313) 885-1520
Fax: (313) 885-1740
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 4301047282 | Michigan |
Profile Details
| NPI number | 1164463758 |
|---|---|
| LBN Legal business name | Boccaccio, John Elliott |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164463758 | NPPES |
| Michigan | MEDICAID | 2583645 |
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