Individual
DR. ANGELA MARIE GRANATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
10105 BANBURRY CROSS DR STE 445, LAS VEGAS, NV 89144-6645
(702) 765-0884
(702) 765-0862
Mailing address
7455 W WASHINGTON AVE STE 460, LAS VEGAS, NV 89128-4338
(702) 765-0884
(702) 765-0862
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2007
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669739827
—
NV
Enumeration date
04/12/2012
Last updated
03/17/2021
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