Organization
SAMUEL J MUCCI M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE A BARC (MEDICAL BILLER)
(248) 283-1115
Entity
Organization
Contact information
Practice address
15590 W 13 MILE RD, SUITE A, BEVERLY HILLS, MI 48025-5642
(248) 283-1115
(248) 283-1119
Mailing address
15590 W 13 MILE RD, SUITE A, BEVERLY HILLS, MI 48025-5642
(248) 283-1115
(248) 283-1119
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301067463
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103269170
—
MI
01
—
2406314511
BCBSM
MI
Enumeration date
03/27/2008
Last updated
11/06/2014
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