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General NPI Number Information
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NPI Number | 1598922783
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Entity Type | Organization
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Legal Business Name | RICHARD A FICI DO PLLC
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 18200 E 10 MILE RD STE 100
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City | EASTPOINTE
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State | MI
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Zip | 48021-1368
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Country | US
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Telephone | 586-772-0727
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Fax |
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Provider Business Mailing Address
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Address Line | 18200 E 10 MILE RD STE 100
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City | EASTPOINTE
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State | MI
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Zip | 48021-1368
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RICHARD ALBERT FICI
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Credential | DO
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Telephone | 586-772-0727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101008247
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License Number State | MI
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