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Individual
FRANK MICUCCI
Active
Individual
FRANK MICUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168951
RH MEDICARE
IA
01
—
17518
WELLMARK BLUE CROSS BLUE
IA
01
—
4554
MIDLANDS
IA
01
—
970014324
RR MEDICARE
IA
Enumeration date
07/28/2006
Last updated
02/17/2016
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