Individual
JASON M RICCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
560 W MITCHELL ST, SUITE 400, PETOSKEY, MI 49770-2275
(231) 487-2490
(231) 487-6055
Mailing address
560 W MITCHELL ST, SUITE 400, PETOSKEY, MI 49770-2275
(231) 487-2490
(231) 487-6055
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301087561
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301087561
MI
Other
Enumeration date
05/14/2007
Last updated
08/06/2014
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