Provider Demographics
NPI:1578662441
Name:CIOCCA, MARIO FRANK JR (MD)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:FRANK
Last Name:CIOCCA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF NORTH CAROLINA CAMPUS HEALTH SERVICE
Mailing Address - Street 2:CB#7470
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-966-3655
Mailing Address - Fax:919-966-9779
Practice Address - Street 1:UNIVERSITY OF NORTH CAROLINA CAMPUS HEALTH SERVICE
Practice Address - Street 2:CB#7470
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-3655
Practice Address - Fax:919-966-9779
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9600127207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine