Provider Demographics
NPI:1346228053
Name:MOCERI, CROSS FRANCIS (DPM)
Entity Type:Individual
Prefix:
First Name:CROSS
Middle Name:FRANCIS
Last Name:MOCERI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39090 GARFIELD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038
Mailing Address - Country:US
Mailing Address - Phone:586-286-8660
Mailing Address - Fax:586-286-8353
Practice Address - Street 1:39090 GARFIELD
Practice Address - Street 2:SUITE 101
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038
Practice Address - Country:US
Practice Address - Phone:586-286-8660
Practice Address - Fax:586-286-8353
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICM000636213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1421099Medicaid
MI1421099Medicaid
OM07460Medicare ID - Type Unspecified