Provider Demographics
NPI:1669584132
Name:FURICCHIA, LOUIS AURELIO (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:AURELIO
Last Name:FURICCHIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:919 RIVARD BLVD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1295
Mailing Address - Country:US
Mailing Address - Phone:313-821-1815
Mailing Address - Fax:313-821-1816
Practice Address - Street 1:919 RIVARD BLVD
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-1295
Practice Address - Country:US
Practice Address - Phone:313-821-1815
Practice Address - Fax:313-821-1816
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010598672085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology