Organization
MICHAEL A CICERO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHEAL ANTHONY CICERO MD (PRESIDENT)
(757) 569-9397
Entity
Organization
Contact information
Practice address
106 FAIRVIEW DR STE C, FRANKLIN, VA 23851-1247
(757) 569-9397
(757) 569-0353
Mailing address
106 FAIRVIEW DR STE C, FRANKLIN, VA 23851-1247
(757) 569-9397
(757) 569-0353
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048159
ANTHEM
VA
01
—
67041
OPTIMA
VA
01
—
823584
MAMSI
VA
05
—
890505G
—
NC
Enumeration date
10/17/2006
Last updated
08/22/2020
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