Individual
PETER M AGNONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
11225 S SAGINAW ST, GRAND BLANC, MI 48439-1285
(810) 694-3937
(810) 694-9876
Mailing address
11225 S SAGINAW ST, GRAND BLANC, MI 48439-1285
(810) 694-3937
(810) 694-9876
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002729
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0995464
HEALTHPLUS OF MICHIGAN
—
01
—
1012177
MCLAREN HEALTH PLAN
—
01
—
16441
M-CARE
—
01
—
900B511570
BLUE CROSS BLUE SHIELD MI
—
05
—
944505380
—
MI
Enumeration date
10/06/2006
Last updated
01/29/2020
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