Individual
MICHAEL J SAMMARCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-5101
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036069461
IL
207V00000X
Obstetrics & Gynecology Physician
2012009159
MO
207V00000X
Obstetrics & Gynecology Physician
4301071412
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000356510
ANTHEM
—
01
—
03621
PHC
MI
01
—
104773
GLHP
MI
01
—
116023
CARE CHOICES
MI
01
—
160059932
RRMC
MI
01
—
1604601321
BCBS MI
MI
01
—
4057483
AETNA
MI
05
—
4503385
—
MI
01
—
5885
HPM
MI
Enumeration date
08/11/2005
Last updated
04/15/2016
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