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General NPI Number Information
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NPI Number | 1205325255
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY TONELLI CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/05/2018
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 1000 W UNIVERSITY DR STE 100
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City | ROCHESTER
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State | MI
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Zip | 48307-1874
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Country | US
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Telephone | 248-402-0266
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Fax |
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Provider Business Mailing Address
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Address Line | 2307 GYSIN CT
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City | BAY CITY
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State | MI
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Zip | 48708-6848
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Country | US
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Telephone | 586-904-8787
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704289502
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License Number State | MI
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