Individual
DR. MICHAEL ANTHONY CICERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
106 FAIRVIEW DR, FRANKLIN, VA 23851-1247
(757) 569-9397
Mailing address
25114 RIVER RUN TRL, ZUNI, VA 23898-3202
(757) 562-7838
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
010141560
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006732798
—
VA
01
—
0218F
BLUE CROSS
NC
01
—
048159
ANTHEM BC & BS
VA
01
—
3657687
CIGNA
VA
01
—
5244135
AETNA
VA
01
—
541436003
CHAMPUS/TRICARE
VA
01
—
600010631
CIGNA HMO
VA
01
—
67041
SENTARA
VA
01
—
823584
OPTIMA, MAMSI, ALLIANCE,
VA
05
—
890505G
—
NC
01
—
98764C
MEDCOST
VA
Enumeration date
01/10/2006
Last updated
07/08/2007
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