Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 5101021091 | MI |
NPI | 1023422888 |
---|---|
Provider Name | Dr. Arman Cicic |
First Address | Wyoming, MI 49519-9606 |
Second Address | Wyoming, MI 49519-9606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 19/06/2014 |