Individual
PAUL L SICURO
Active
Individual
PAUL L SICURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00028778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039587
LABOR & INDUSTRY
WA
01
—
300085697
RAILROAD MEDICARE
—
01
—
806245800
IDAHO MEDICAID
WA
05
—
8156846
—
WA
01
—
8893441
MEDICARE PTAN
WA
01
—
8894522
MEDICARE WINSLOW PTAN
WA
01
—
MD8779
ALASKA MEDICAID
WA
01
—
SI3333
BLUE SHIELD
WA
01
—
US0864876
AETNA/USHC SPECIALIST
WA
Enumeration date
08/20/2006
Last updated
10/19/2010
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