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MR. MICHAEL G. CANELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
225 MEDICAL CENTER DR, SUITE 405, PADUCAH, KY 42003-7914
(270) 441-4750
(270) 441-4770
Mailing address
225 MEDICAL CENTER DR, SUITE 405, PADUCAH, KY 42003-7914
(270) 441-4750
(270) 441-4770

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
671A
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000361077
BCBS
05
74307802
KY
01
P00257580
RAILROAD MEDICARE
Enumeration date
10/02/2006
Last updated
08/03/2012
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