Provider Demographics
NPI:1053376202
Name:ALIMENTI, SIGITA (MD)
Entity type:Individual
Prefix:
First Name:SIGITA
Middle Name:
Last Name:ALIMENTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MOMANY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2178
Mailing Address - Country:US
Mailing Address - Phone:269-982-2099
Mailing Address - Fax:269-982-1950
Practice Address - Street 1:405 MOMANY DRIVE
Practice Address - Street 2:
Practice Address - City:ST JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2178
Practice Address - Country:US
Practice Address - Phone:269-982-2099
Practice Address - Fax:269-982-1950
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700A110160OtherCMC BCBS GROUP ID #
MI151173OtherGLHP PIN #
MISA080747OtherBCBS PROVIDER ID #
MI1053376202Medicaid
MI104769332Medicaid
MISA080747OtherBCBS PROVIDER ID #
OM3919007Medicare PIN
MI1053376202Medicaid