Individual
MARK MICELI
Active
Individual
MARK MICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
302
NC
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
302
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
302
NC
213ES0131X
Foot Surgery Podiatrist
302
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004118131
AETNA
—
01
—
0807M
BCBS
—
01
—
341408479
UHC
—
05
—
890183P
—
NC
Enumeration date
11/30/2005
Last updated
08/09/2022
Update your record
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