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Contact Information

PETER BISTOLARIDES, MD
4201 CAMPUS RIDGE DRIVE
MIDLAND, MI48640
 Phone: 989-839-1795
 Fax: 989-839-1785
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PETER BISTOLARIDES · (Male)

NPI Number 1407838048
Status Active
Credentials MD
Entity Individual
Enumeration date 11/18/2005
Last updated 11/03/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301064856
  • MI Medicaid 104905069
  • Other 156543 GREAT LAKES HEALTH PLAN
  • Other 0993608 HEALTHPLUS OF MICHIGAN
  • Other P00348487 RAILROAD MEDICARE
  • MI Other 020G361410 BCBSM GROUP PIN
  • MI Other PB064856 STATE LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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