Miceli, Mark

Miceli, Mark is an individual health care provider with primary practice located at 603 Cox Rd , Gastonia NC 28054-3432. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Miceli, Mark can be contacted via phone (704) 867-7388.

Contact Information

Primary practice address
603 Cox Rd Gastonia NC 28054-3432
Phone: (704) 867-7388
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 302 North Carolina
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 302 North Carolina
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 302 North Carolina
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 302 North Carolina

Profile Details

NPI number 1881678118
LBN Legal business name Miceli, Mark
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Aug 9th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881678118 NPPES
Other 341408479 UHC
MEDICAID 890183P UHC
Other 0004118131 UHC
Other 0807M UHC

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