Organization
INTERNAL MEDICINE CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOHN PETRUSO M.D. (OWNER)
(702) 252-0670
Entity
Organization
Contact information
Practice address
6726 COLEY AVE, LAS VEGAS, NV 89146-6514
(702) 252-0670
Mailing address
840 S RANCHO DR # 4-336, LAS VEGAS, NV 89106-3837
(702) 252-0670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6283
NV
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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