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NPI Code Detail

MEDICARE: CARRIE ANN-BUSCH RICCI MD

MEDICARE: CARRIE ANN-BUSCH RICCI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician22411WI
2208000000XPediatrics Physician4301087388MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275543191
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE ANN-BUSCH RICCI MD
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1160 KEPLER DR
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-8321
Country : US
Telephone Number : 920-288-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 06/20/2025

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Directions to “ CARRIE ANN-BUSCH RICCI MD” Practice Location

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