Individual
MATTEO CICCARELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4401 WORNALL ROAD, KANSAS CITY, MO 64111
(816) 512-7440
Mailing address
751 ST. CLAIR PARKWAY, CORUNNA, ONTARIO N0N 1-G0
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/14/2026
Last updated
05/14/2026
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