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General NPI Number Information
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NPI Number | 1467414433
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Entity Type | Individual
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Provider Name | AMERICO MICHAEL MINOTTI JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 250 JOHNSON RIDGE MEDICAL PARK
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City | ELKIN
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State | NC
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Zip | 28621-2443
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Country | US
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Telephone | 336-526-1977
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Fax | 336-526-0061
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Provider Business Mailing Address
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Address Line | 250 JOHNSON RIDGE MEDICAL PARK
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City | ELKIN
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State | NC
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Zip | 28621-2443
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Country | US
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Telephone | 336-526-1977
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Fax | 336-526-0061
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 96-00345
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License Number State | NC
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