Individual
BENJAMIN JOHN PUCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 SAINT ANTOINE ST STE 8A&8B, DETROIT, MI 48201-2153
(313) 745-4275
Mailing address
400 MACK AVE, DETROIT, MI 48201-2136
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301515133
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2020
Last updated
07/25/2025
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