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Organization

JOHN M CILLUFFO MD PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN M CILLUFFO M.D. (PRESIDENT)
(231) 348-2811
Entity
Organization

Contact information

Practice address
2202 MITCHELL PARK DRIVE, PETOSKEY, MI 49770-2070
(231) 348-2811
Mailing address
PO BOX 2070, PETOSKEY, MI 49770-2070
(231) 348-2811

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301044523
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1402410051
BCBS OF MICHIGAN
MI
05
1777018-10
MI
Enumeration date
12/18/2009
Last updated
12/18/2009
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