Basic Information
| Provider Information | |||||||||
| NPI: | 1215900766 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARRINO | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 947 | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296790947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8648884464 | ||||||||
| FaxNumber: | 8648884462 | ||||||||
| Practice Location | |||||||||
| Address1: | 905 S 8TH ST STE B | ||||||||
| Address2: | |||||||||
| City: | DEMING | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880304037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755437200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 10/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080A0000X | 10179 | SC | Y | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine |
ID Information
| ID | Type | State | Issuer | Description | 101794 | 05 | SC | MEDICAID | GP1060 | 05 | SC | MEDICAID | RHC100 | 05 | SC | MEDICAID |