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NPI Code Detail

MEDICARE: JOHN CHARLES SOMOGYI MD

MEDICARE: JOHN CHARLES SOMOGYI 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
1207RC0000XCardiovascular Disease Physician4301034213MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3OH-26467004OTHERMIMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1060 500 7431OTHERMIBLUE CROSS BLUE SHEILD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447252093
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN CHARLES SOMOGYI MD
Provider Business Mailing Address
First Line : 25195 KELLY RD
Second Line : SUITE A
City : ROSEVILLE
State : MI
Zip : 48066-4909
Country : US
Telephone Number : 586-775-4594
Fax Number : 586-775-4506
Provider Business Practice Location Address
First Line : 25195 KELLY RD
Second Line : SUITE A
City : ROSEVILLE
State : MI
Zip : 48066-4909
Country : US
Telephone Number : 586-775-4594
Fax Number : 586-775-4506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 03/07/2023

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Directions to “ JOHN CHARLES SOMOGYI MD” Practice Location

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