Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 4547 | NV |
NPI | 1023164993 |
---|---|
Provider Name | Dr. Michael D. Digregorio |
First Address | Mt Charleston, NV 89124-9141 |
Second Address | Las Vegas, NV 89146-0842 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E79738 | (02) | NV |