Individual
DR. SALVATORE J MICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
601 S 169 HIGHWAY, SMITHVILLE, MO 64089
(816) 532-7141
(816) 532-7209
Mailing address
PO BOX 504538, SAINT LOUIS, MO 63150-4538
(816) 932-7940
(816) 932-7957
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
05-30894
KS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2004017637
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2073203000
—
MO
Enumeration date
08/31/2006
Last updated
05/01/2012
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