Individual
JULIA A DICICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3130 N DIXIE HWY, TROY, OH 45373-1337
(937) 440-4600
(937) 339-4056
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34005744D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000315965
BCBS
OH
05
—
0169106
—
OH
01
—
P00263028
RR MEDICARE
—
Enumeration date
05/27/2006
Last updated
06/10/2008
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