DR. JOHN MICHAEL FORMOLO M.D. NPI 1619921475

NPI Information

NPI: 1619921475
Provider Name: DR. JOHN MICHAEL FORMOLO, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Address:
1000 E PARIS AVE SE
STE 200
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 949-8554
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DR. John Michael Formolo, M.D. is a cardiovascular disease internal medicine in Grand Rapids, MI. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. DR. John Michael Formolo, M.D. NPI is 1619921475. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1000 E PARIS AVE SE
STE 200
GRAND RAPIDS, MI
ZIP 49546-680
Phone: (616) 949-8554

The enumeration date for this NPI number is 5/19/2006 and was last updated on 3/31/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	JF036515	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	N90310006	MEDICARE PIN	MICHIGAN
2	P00322545	OTHER	MICHIGAN	MEDICARE RRR
3	B44860	MEDICARE UPIN	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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