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Organization

GENE CAICCO,D.P.M., PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GENE JOSEPH CAICCO D.P.M. (OWNER PODIATRIST)
(586) 573-7470
Entity
Organization

Contact information

Practice address
11900 E 12 MILE RD, SUITE 102, WARREN, MI 48093-3487
(586) 573-7470
(586) 573-0850
Mailing address
11900 E 12 MILE RD, SUITE 102, WARREN, MI 48093-3487
(586) 573-7470
(586) 573-0850

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001745
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4246887
MI
01
48OE01215
BLUE CROSS/BLUE SHIELD
MI
01
CH7071
PALMETTO GBA
MI
Enumeration date
10/04/2006
Last updated
11/15/2012
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