Individual
DR. MICHAEL J OCCHIETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1711 SOUTH STEPHENSON AVENUE, SUITE 100, IRON MOUNTAIN, MI 49801
(906) 776-5250
(906) 228-0217
Mailing address
1711 SOUTH STEPHENSON AVENUE, SUITE 100, IRON MOUNTAIN, MI 49801
(906) 779-9870
(906) 779-5888
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MO063234
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300220077
BLUE CROSS
MI
05
—
32564300
—
WI
01
—
383105579
TAX ID
—
05
—
4318832
—
MI
Enumeration date
01/12/2006
Last updated
07/17/2019
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