Individual
NICHOLAS JAMES CORIASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(800) 248-6777
Mailing address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(800) 248-6777
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
5101025590
MI
207RI0011X
Interventional Cardiology Physician
Primary
5101025590
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2017
Last updated
06/14/2024
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