Individual
MICHAEL A. MECCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2020 PALOMINO LANE, STE # 100, LAS VEGAS, NV 89106-4894
(702) 759-8600
(702) 384-1815
Mailing address
2020 PALOMINO LANE, STE # 100, LAS VEGAS, NV 89106-4894
(702) 759-8600
(702) 384-1815
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15183
NV
2085R0202X
Diagnostic Radiology Physician
232098
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02797762
—
NY
05
—
1992729727
—
NV
01
—
874T41
MEDICARE
NY
01
—
P01321079
RR MEDICARE DRS
NV
01
—
P01321081
RR MEDICARE DR
NV
Enumeration date
07/26/2006
Last updated
07/22/2014
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