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Individual

BRIAN FACIONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5515 CLEVELAND AVE, SUITE 5, STEVENSVILLE, MI 49127-9670
(269) 429-9644
(269) 429-4002
Mailing address
5515 CLEVELAND AVE, SUITE 5, STEVENSVILLE, MI 49127-9670
(269) 429-9644
(269) 429-4002

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101020006
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720349210
MI
Enumeration date
05/31/2012
Last updated
08/26/2016
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