Organization
JUAN A. ESTIGARRIBIA MD. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN A ESTIGARRIBIA M.D. (PRESIDENT)
(313) 277-0075
Entity
Organization
Contact information
Practice address
23550 PARK ST., SUITE 201, DEARBORN, MI 48124
(313) 277-0075
(313) 277-8029
Mailing address
23550 PARK ST., SUITE 201, DEARBORN, MI 48124
(313) 277-0075
(313) 277-8029
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
4301038833
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H244980
BCBSM
MI
05
—
2021269 10
—
MI
01
—
DH1124
MEDICARE RAILROAD
MI
01
—
R-12387506
FED BCBSM
MI
Enumeration date
02/17/2011
Last updated
02/17/2011
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