MEDICARE: DR. WILLIAM D VECCHIONI DC

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	111N00000X	Chiropractor	2301004654	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0Q25074	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1871573998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM D VECCHIONI DC

Provider Business Mailing Address
First Line	:	4218 PELHAM
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-3121
Country	:	US
Telephone Number	:	313-277-1100
Fax Number	:	313-277-5787

Provider Business Practice Location Address
First Line	:	4218 PELHAM
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-3121
Country	:	US
Telephone Number	:	313-277-1100
Fax Number	:	313-277-5787

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

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	10/25/2011

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