Individual
DAVID MATTHEW VIVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301060296
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006476
MIDWEST HEALTH PLANS
MI
05
—
104087038
—
MI
01
—
116527
GREAT LAKES HEALTH PLAN
MI
01
—
200H261280
BCBSM/BCN
MI
01
—
236661
MEDICARE PROVIDER NO
MI
01
—
50807
OMNICARE HEALTH PLANS
MI
01
—
7979762
AETNA
MI
01
—
G97179
HEALTH ALLIANCE PLANS
MI
Enumeration date
05/11/2006
Last updated
08/11/2020
Update your record
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