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NPI Code Detail

MEDICARE: DR. SANDY ANNA DIPONIO O.D.

MEDICARE:  DR. SANDY ANNA DIPONIO  O.D.
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
1152W00000XOptometrist4901003814MI

General Provider Information

NPI Number : 1801960737
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANDY ANNA DIPONIO O.D.
Provider Business Mailing Address
First Line : 33620 ARGONNE RD
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48335-1404
Country : US
Telephone Number : 248-427-0083
Fax Number :
Provider Business Practice Location Address
First Line : 2550 S TELEGRAPH RD STE 100
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-0951
Country : US
Telephone Number : 248-258-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 04/05/2018

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Directions to “ DR. SANDY ANNA DIPONIO O.D.” Practice Location

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