Individual
LINO SEVANDAL DIAL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1101 S. MISSION STREET, MT. PLEASANT, MI 48858
(989) 773-9700
(989) 779-9701
Mailing address
5511 WEST U.S. HIGHWAY 10, LUDINGTON, MI 49431
(231) 843-1553
(231) 845-5515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101014103
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N85680
MEDICARE GROUP
MI
05
—
1245228568
—
MI
01
—
700E310160
BCBS GROUP
MI
Enumeration date
10/11/2005
Last updated
06/22/2011
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