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Individual

JOHN M OGRADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2393 SCHUST RD, SAGINAW, MI 48603-1334
(989) 793-2820
(989) 793-9132
Mailing address
2393 SCHUST RD, SAGINAW, MI 48603-1334
(989) 793-2820
(989) 793-9132

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301054868
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0G30089
GROUP BCBSM ID
MI
01
0G36036
GROUP MEDICARE ID
01
1427090976
GROUP NPI
01
43010054868
LICENSE #
MI
01
CA3610
RAILROAD MEDICARE
MI
Enumeration date
09/02/2005
Last updated
09/18/2023
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