Provider Demographics
NPI:1720157787
Name:CURCIONE, MICHAEL DANTE (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DANTE
Last Name:CURCIONE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 WARNER PL
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9110
Mailing Address - Country:US
Mailing Address - Phone:734-944-6697
Mailing Address - Fax:
Practice Address - Street 1:1601 E US HIGHWAY 223
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-4454
Practice Address - Country:US
Practice Address - Phone:517-265-9883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003925152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU-80937Medicare UPIN
MION-3005000-2Medicare ID - Type Unspecified