Individual
JOHN M CICCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3510 HWY 17 NORTH, STE 325, MT. PLEASANT, SC 29466-8232
(843) 606-8982
(843) 606-8077
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2454
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
34588
SC
207RC0000X
Cardiovascular Disease Physician
MA37832
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010000347500
AMERICHOICE
—
01
—
0199893000
AMERIHEALTH
—
01
—
0963382002
CIGNA
—
01
—
1075758
HORIZON MERCY
—
05
—
1747304
—
NJ
01
—
1K9389
HEALTHNET
—
01
—
28F431
WELLCHOICE
—
01
—
4094234
AETNA
—
01
—
5710570
GHI
—
01
—
81554
AMERIGROUP
—
01
—
ES226
OXFORD
—
Enumeration date
10/04/2005
Last updated
10/19/2015
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