MEDICARE: RICHARD A FICI DO

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
1	207Q00000X	Family Medicine Physician	5101008247	MI

General Provider Information

NPI Number	:	1730292079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A FICI DO

Provider Business Mailing Address
First Line	:	20905 E 12 MILE RD
Second Line	:	STE 300
City	:	ROSEVILLE
State	:	MI
Zip	:	48066-6501
Country	:	US
Telephone Number	:	586-772-0727
Fax Number	:	586-772-0640

Provider Business Practice Location Address
First Line	:	20905 E 12 MILE RD
Second Line	:	STE 300
City	:	ROSEVILLE
State	:	MI
Zip	:	48066-6501
Country	:	US
Telephone Number	:	586-772-0727
Fax Number	:	586-772-0640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	10/14/2021

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