Individual
JOHN PISPIDIKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C, DC, DACNB
Contact information
Practice address
2243 E 12 MILE RD, WARREN, MI 48092-5644
(214) 717-1859
(586) 573-8100
Mailing address
2243 E 12 MILE RD, WARREN, MI 48092-5644
(214) 717-1859
(586) 573-8100
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC8263
TX
111NN0400X
Neurology Chiropractor
2301009328
MI
363L00000X
Nurse Practitioner
Primary
4704287416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002102403
—
TX
01
—
8M8882
BCBS
TX
01
—
8P2242
BCBS
TX
01
—
8P5600
BCBS
TX
01
—
8R1720
BCBS
TX
Enumeration date
05/19/2006
Last updated
12/07/2017
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