Individual
DR. MICHAIL VITELLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 HARRISON ST, SUITE 250, JOHNSON CITY, NY 13790
(607) 770-8600
Mailing address
33 LEWIS RD, 2ND FLOOR, BINGHAMTON, NY 13905-1048
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
275080
NY
207RI0011X
Interventional Cardiology Physician
275080
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2009
Last updated
07/24/2018
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