Organization
MICHAEL OCCHIETTI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMES OCCHIETTI MD (PHYSICIAN)
(906) 779-9870
Entity
Organization
Contact information
Practice address
1711 S STEPHENSON AVE, SUITE 100, IRON MOUNTAIN, MI 49801-3639
(906) 779-9870
(906) 779-5888
Mailing address
1711 S STEPHENSON AVE, SUITE 100, IRON MOUNTAIN, MI 49801-3639
(906) 779-9870
(906) 779-5888
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301063234
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300220077
BLUE CROSS MI
MI
01
—
32564300
WISC MEDICAID
WV
05
—
4318832
—
MI
Enumeration date
04/13/2009
Last updated
04/13/2009
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