Dr Michael C Dicello, MD | |
1188 N 15th Ave Ste 3, Bozeman, MT 59715-3290 | |
(406) 582-1111 | |
(406) 582-1112 |
Full Name | Dr Michael C Dicello |
---|---|
Gender | Male |
Speciality | Allergy/immunology |
Experience | 31 Years |
Location | 1188 N 15th Ave Ste 3, Bozeman, Montana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720083173 | NPI | - | NPPES |
01961568 | Medicaid | NY | |
96G431 | Other | NY | BCBS NORTHEAST NEW YORK |
0VN1993 | Medicaid | VT | |
7525992-001 | Other | VT | CIGNA |
03V100 | Other | VT | MVP |
48079 | Other | VT | BLUE CROSS BLUE SHIELD VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207K00000X | Allergy & Immunology | 42-000-9879 (Vermont) | Secondary |
207K00000X | Allergy & Immunology | 11976 (Montana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Bozeman Health Deaconess Hospital | Bozeman, MT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Equanimity Health Care Pc | 2365614369 | 2 |
Entity Name | Equanimity Health Care Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356637656 PECOS PAC ID: 2365614369 Enrollment ID: O20111018000254 |
Mailing Address | Practice Location Address |
---|---|
Dr Michael C Dicello, MD 1188 N 15th Ave Ste 3, Bozeman, MT 59715-3290 Ph: (406) 582-1111 | Dr Michael C Dicello, MD 1188 N 15th Ave Ste 3, Bozeman, MT 59715-3290 Ph: (406) 582-1111 |
Dr. Michael C Zacharisen, MD Allergy & Immunology Medicare: Not Enrolled in Medicare Practice Location: 4265 Fallon St Ste 3a, Bozeman, MT 59718 Phone: 406-451-7017 Fax: 406-451-7020 | |
Alan A Wanderer, MD Allergy & Immunology Medicare: Not Enrolled in Medicare Practice Location: 2055 N 22nd Ave, Ste 1, Bozeman, MT 59718 Phone: 406-582-1111 Fax: 406-582-1112 |