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NPI Code Detail

MEDICARE: JOHN M OGRADY MD

MEDICARE: JOHN M OGRADY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician4301054868MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CA3610OTHERMIRAILROAD MEDICARE
30G36036OTHERGROUP MEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11427090976OTHERGROUP NPI
40G30089OTHERMIGROUP BCBSM ID
543010054868OTHERMILICENSE #

General Provider Information

NPI Number : 1114911351
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN M OGRADY MD
Provider Business Mailing Address
First Line : 2393 SCHUST RD
Second Line :
City : SAGINAW
State : MI
Zip : 48603-1334
Country : US
Telephone Number : 989-793-2820
Fax Number : 989-793-9132
Provider Business Practice Location Address
First Line : 2393 SCHUST RD
Second Line :
City : SAGINAW
State : MI
Zip : 48603-1334
Country : US
Telephone Number : 989-793-2820
Fax Number : 989-793-9132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 09/18/2023

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Directions to “ JOHN M OGRADY MD” Practice Location

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