| Jeffrey E. Puccio M.d., P.c. | |
|
2021 Monroe St Suite 101 Dearborn MI 48124-2926 | |
| (313) 277-4177 | |
| (313) 277-4157 |
| Full Name | Jeffrey E. Puccio M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2021 Monroe St, Dearborn, Michigan |
| Authorized Official Name and Position | Jeffrey E Puccio (PRESIDENT) |
| Authorized Official Contact | 3132774177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey E. Puccio M.d., P.c. 2021 Monroe St Suite 101 Dearborn MI 48124-2926 Ph: (313) 277-4177 | Jeffrey E. Puccio M.d., P.c. 2021 Monroe St Suite 101 Dearborn MI 48124-2926 Ph: (313) 277-4177 |
| NPI Number | 1619245461 |
|---|---|
| Provider Enumeration Date | 12/08/2011 |
| Last Update Date | 12/08/2011 |
| Medicare PECOS PAC ID | 7113194135 |
|---|---|
| Medicare Enrollment ID | O20120114000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619245461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 4301052835 (Michigan) | Primary |
| Provider Name | Jeffrey E Puccio |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275507733 PECOS PAC ID: 8022285048 Enrollment ID: I20120114000036 |
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