Individual
ANTHONY M AVELLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
1501 N CAMPBELL AVE, TUCSON, AZ 85724-8761
(520) 626-2164
Mailing address
1501 N CAMPBELL AVE, TUCSON, AZ 85724-5070
(520) 626-2164
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
4301115254
MI
207T00000X
Neurological Surgery Physician
Primary
66853
AZ
207T00000X
Neurological Surgery Physician
G175077
CA
207T00000X
Neurological Surgery Physician
MD00033972
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0252115
L&I
WA
05
—
1730279621
—
WA
01
—
590
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/13/2006
Last updated
08/14/2024
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