Organization
JOEL DINVERNO MD PC
Active
Other names
Sacred Heart Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL DINVERNO MD (OWNER)
(517) 522-6100
Entity
Organization
Contact information
Practice address
11755 E MICHIGAN AVE, GRASS LAKE, MI 49240-9219
(517) 522-6100
(517) 522-4715
Mailing address
11755 E MICHIGAN AVE, GRASS LAKE, MI 49240-9219
(517) 522-6100
(517) 522-4715
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301073676
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104717265
—
MI
01
—
3503810581
BCBS
MI
Enumeration date
06/22/2012
Last updated
06/22/2012
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