Tactical Medical Providers

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

4301078278 Issued in MI

Legal business name

TACTICAL MEDICAL PROVIDERS

Practice address

44471 Midway Dr
Novi, MI 48375-3949

Phone

(248) 773-8923

NPI assigned

Apr 6, 2012

Last updated

Mar 30, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Glenn Cipullo

Title

President

Phone

(248) 773-8923

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396137600000",
    "number": "1801152590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44471 MIDWAY DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44471 MIDWAY DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483753949",
            "telephone_number": "248-773-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACTICAL MEDICAL PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2014-03-30",
        "status": "A",
        "authorized_official_last_name": "CIPULLO",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-773-8923"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MI",
            "license": "4301078278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Marie Szakal
• Daniel Robert Szatkowski
• Alana Taber
• Amanda Tabor
• Joan Marie Tacey
• Joan Taele
• Rosalie Taflinger
• Amanda Tafua
• Xenia Taganova
• Hassan Taher

• Multi-Specialty Clinic/Center in Novi, MI
• Providers in Novi, MI by specialty
• Multi-Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.