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NPI Code Detail

MEDICARE: MICHAEL ANTHONY VACCARIELLO MD

MEDICARE: MICHAEL ANTHONY VACCARIELLO 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
1207X00000XOrthopaedic Surgery Physician4301088476MI
2207X00000XOrthopaedic Surgery PhysicianMT200159PA

General Provider Information

NPI Number : 1710196761
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ANTHONY VACCARIELLO MD
Provider Business Mailing Address
First Line : 537 W MAIN ST
Second Line :
City : IONIA
State : MI
Zip : 48846-1652
Country : US
Telephone Number : 616-523-1010
Fax Number : 616-523-1407
Provider Business Practice Location Address
First Line : 537 W MAIN ST
Second Line :
City : IONIA
State : MI
Zip : 48846-1652
Country : US
Telephone Number : 616-523-1010
Fax Number : 616-523-1407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 12/20/2023

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