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General NPI Number Information
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NPI Number | 1811952658
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Entity Type | Individual
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Provider Name | MICHAEL J VIETTI MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 12/28/2020
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Provider Practice Location Address
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Address Line | 915 MICHIGAN ST
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City | SIDNEY
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State | OH
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Zip | 45365-2401
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Country | US
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Telephone | 937-494-5242
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Fax | 937-494-5243
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Provider Business Mailing Address
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Address Line | 915 MICHIGAN ST
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City | SIDNEY
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State | OH
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Zip | 45365-2401
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Country | US
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Telephone | 937-494-5242
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Fax | 937-494-5243
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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 | 35069405V
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License Number State | OH
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