Dicello, Michael C

Dicello, Michael C is an individual health care provider with primary practice located at 1188 N 15Th Ave Ste 3 , Bozeman MT 59715-3290. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Dicello, Michael C can be contacted via phone (406) 582-1111.

Contact Information

Primary practice address
1188 N 15Th Ave Ste 3 Bozeman MT 59715-3290
Phone: (406) 582-1111
Fax: (406) 582-1112
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 42-000-9879 Vermont
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 11976 Montana

Profile Details

NPI number 1720083173
LBN Legal business name Dicello, Michael C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Jul 28th, 2023 - about 2 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 1720083173 NPPES
New York MEDICAID 01961568
New York Other 96G431
New York MEDICAID 0VN1993
New York Other 7525992-001
New York Other 03V100
New York Other 48079

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