Individual
DR. MICHAEL ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1600 MEDICAL PKWY, CARSON CITY, NV 89703
(702) 878-0070
(702) 209-2064
Mailing address
9127 W RUSSELL RD STE 110, LAS VEGAS, NV 89148-1253
(702) 878-0070
(702) 209-2064
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DO1734
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831218148
—
NV
Enumeration date
03/28/2007
Last updated
08/14/2018
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