Individual
ADAM JOSEPH PERISSINOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-3330
Mailing address
1212 CARRIAGE LANE, LASALLE, ONTARIO N9H 1-Z8
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200965-6
MN
163W00000X
Registered Nurse
4704285098
MI
163W00000X
Registered Nurse
RN1033014
DC
367500000X
Certified Registered Nurse Anesthetist
Primary
4704285098
MI
Other
Enumeration date
03/09/2017
Last updated
05/10/2023
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