Provider Demographics
NPI:1447677679
Name:GHASSIBI, MICHAEL CIRIL (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CIRIL
Last Name:GHASSIBI
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:11277 VERNON PL
Mailing Address - Street 2:STE 200
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3719
Mailing Address - Country:US
Mailing Address - Phone:814-724-1252
Mailing Address - Fax:814-333-8871
Practice Address - Street 1:1100 VIRGINIA AVENUE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-2663
Practice Address - Fax:573-882-1760
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2020-05-26
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Provider Licenses
StateLicense IDTaxonomies
MO2019009763207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery