Individual
MICHAEL ADAM MONDELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
559 VINCENT ST, COLORADO SPRINGS, CO 80914-1541
(719) 556-5618
Mailing address
3209 BARKSDALE DR, BELLEVUE, NE 68123-1440
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.0008004
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2019
Last updated
04/19/2024
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