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NPI Code Detail

MEDICARE: MR. MARKOS ANGELIDES

MEDICARE: MR. MARKOS ANGELIDES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) Counselor07949-CNV

General Provider Information

NPI Number : 1265879365
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARKOS ANGELIDES
Provider Business Mailing Address
First Line : 119 E LONG ST
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-2505
Country : US
Telephone Number : 775-461-0025
Fax Number :
Provider Business Practice Location Address
First Line : 119 E LONG ST
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-2505
Country : US
Telephone Number : 775-461-0025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2013
Last Update Date : 02/25/2025

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