Individual
MICHAEL T CICERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-6777
Mailing address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-6777
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
60485-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100029400
—
WI
Enumeration date
01/21/2009
Last updated
01/09/2024
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