Individual
MICHAEL SALVATORE FESTENESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
8571 W LAKE MEAD BLVD, STE #120, LAS VEGAS, NV 89128-7631
(702) 360-5194
(702) 319-4754
Mailing address
8571 W LAKE MEAD BLVD, SUITE #120, LAS VEGAS, NV 89128-7631
(702) 360-5194
(702) 319-4754
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
513
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
513
NV ST BD MED EXAMINERS ID
NV
01
—
CS00178
NV ST BD PHARMACY CERT#
NV
Enumeration date
06/30/2005
Last updated
03/07/2023
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