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Individual

RICHARD LEE MOGERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9991 COOPER CREEK RD, FREE SOIL, MI 49411-9717
(231) 723-0752
Mailing address
9991 COOPER CREEK RD, FREE SOIL, MI 49411-9717
(231) 723-0752

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301045763
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0535763
BCBS
05
2869366
MI
Enumeration date
08/31/2006
Last updated
04/07/2021
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