Healthcare Provider Details

I. General information

NPI: 1417098567
Provider Name (Legal Business Name): FILIPPO CREMONINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 S PECOS RD STE 101
LAS VEGAS NV
89120-3768
US

IV. Provider business mailing address

7315 S. PECOS ROAD SUITE 101
LAS VEGAS NV
89120
US

V. Phone/Fax

Practice location:
  • Phone: 702-982-7240
  • Fax: 702-952-5444
Mailing address:
  • Phone: 702-982-7240
  • Fax: 702-952-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number49957
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number246157
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number14135
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: