Provider Demographics
NPI:1598793614
Name:MARGHERIO, ALAN RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:RICHARD
Last Name:MARGHERIO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:39650 ORCHARD HILL PL
Mailing Address - Street 2:200
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5331
Mailing Address - Country:US
Mailing Address - Phone:248-319-0161
Mailing Address - Fax:248-319-0170
Practice Address - Street 1:1179 EAST PARIS SE
Practice Address - Street 2:250
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546
Practice Address - Country:US
Practice Address - Phone:616-942-2406
Practice Address - Fax:616-942-1165
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2020-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301056112207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1598793614Medicaid
F93594Medicare UPIN
OM21980009Medicare ID - Type Unspecified
F93594Medicare UPIN
OM21980009Medicare ID - Type Unspecified