Individual
DR. ANDREW M STARICCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21000 E 12 MILE RD STE 112, SAINT CLAIR SHORES, MI 48081-1156
(586) 314-0080
(877) 673-3562
Mailing address
50505 SCHOENHERR RD STE 290, SHELBY TOWNSHIP, MI 48315-3141
(586) 314-0080
(877) 673-3562
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301054487
MI
207RP1001X
Pulmonary Disease Physician
4301054487
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E00425
BLUE CROSS OF MICHIGAN
MI
01
—
290010212
RAILROAD MEDICARE
MI
01
—
290F349720
BLUE CROSS OF MICHIGAN
MI
05
—
3371675
—
MI
01
—
AS054487
STATE LICENSE NUMBER
MI
01
—
CE4301
RAILROAD MEDICARE GROUP
MI
Enumeration date
07/12/2006
Last updated
03/11/2025
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