Organization
MARIO N CORACI PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO CORACI PC (OWNER)
(586) 263-8181
Entity
Organization
Contact information
Practice address
16700 21 MILE RD, SUITE 102, MACOMB, MI 48044-4887
(586) 263-8181
Mailing address
16700 21 MILE RD, SUITE 102, MACOMB, MI 48044-4887
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
MC0001096
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104566
PRIORITY HEALTH HMO/PPO
MI
01
—
1233580002
WELLNESS HEALTH PLANS
MI
01
—
17058
M-CARE
MI
05
—
2125505
—
MI
01
—
480002350
TRAVELERS MEDICARE
MI
01
—
485505096
BLUE CROSS BLUE SHEILD
MI
01
—
P45316
BLUE CARENETWORK
MI
01
—
T34328
HAP
MI
Enumeration date
01/07/2008
Last updated
10/04/2010
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