Individual
DOMINIC MICHAEL CANNELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
407 S SCHWARTZ AVE STE 101, FARMINGTON, NM 87401-5925
(505) 609-6595
(505) 609-6579
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
49494
MN
Other
Enumeration date
05/17/2006
Last updated
02/24/2020
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