Individual
DEAN A. SICILIANO
Active
Individual
DEAN A. SICILIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
20136
WV
2085R0202X
Diagnostic Radiology Physician
Primary
35-07-0141
OH
2085R0204X
Vascular & Interventional Radiology Physician
20136
WV
2085R0204X
Vascular & Interventional Radiology Physician
35-070141
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007131
ANTHEM BCBS
—
01
—
000000193128
UNISON MEDICAID #
OH
01
—
001714093
MOUNTAIN STATE BCBS
—
05
—
0122089000
—
WV
01
—
0247674
MOLINA MEDICAID #
OH
01
—
300071295
RR MEDICARE
OH
01
—
310917085031
OH MEDICAID CARESOURCE
OH
Enumeration date
06/08/2006
Last updated
12/04/2020
Update your record
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