Individual
MICHAEL GIRARD CICCOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
833 CHESTNUT ST STE 1220, PHILADELPHIA, PA 19107-4413
(800) 321-9999
(267) 479-1321
Mailing address
833 CHESTNUT ST STE 520, PHILADELPHIA, PA 19107-4430
(609) 677-7003
(267) 339-3761
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD040661E
PA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25MA06744600
NJ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD040661E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0116226
AETNA
PA
01
—
0529117000
IBC
PA
01
—
1260028
CIGNA
—
Enumeration date
05/30/2006
Last updated
06/27/2025
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