Provider Demographics
NPI:1124512793
Name:VALENTI, GIANNA GUZZARDO (MD)
Entity type:Individual
Prefix:DR
First Name:GIANNA
Middle Name:GUZZARDO
Last Name:VALENTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GIANNA
Other - Middle Name:MARIA
Other - Last Name:GUZZARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3901 BEAUBIEN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2196
Mailing Address - Country:US
Mailing Address - Phone:313-745-5515
Mailing Address - Fax:313-745-5237
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2196
Practice Address - Country:US
Practice Address - Phone:313-745-5515
Practice Address - Fax:313-745-5237
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43015052252080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1124512793Medicaid