Organization
ALFONSO G LLANTO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOSEPHINE A LLANTO (OFFICE MANAGER)
(269) 463-5711
Entity
Organization
Contact information
Practice address
3973 M 140, WATERVLIET, MI 49098
(269) 463-5711
(269) 463-2885
Mailing address
POB 127, WATERVLIET, MI 49098
(269) 463-5711
(269) 463-2885
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
AL038737
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1101156072
BCBS
—
05
—
2093395
—
MI
01
—
P00061231
RAILROAD MEDICARE
—
Enumeration date
09/07/2006
Last updated
06/23/2010
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