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Individual

DR. RICHARD D CECCONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1711 S STEPHENSON AVE, SUITE 305, IRON MOUNTAIN, MI 49801-3637
(906) 774-0330
(906) 774-2584
Mailing address
1711 S STEPHENSON AVE, SUITE 305, IRON MOUNTAIN, MI 49801-3637
(906) 774-0330
(906) 774-2584

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301047328
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1820146
MI
05
30846000
WI
Enumeration date
07/31/2006
Last updated
07/08/2007
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