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General NPI Number Information
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NPI Number | 1922057322
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Entity Type | Individual
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Provider Name | WALDO AVELLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 1012 E 2ND ST
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City | DULUTH
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State | MN
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Zip | 55805-2200
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Country | US
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Telephone | 218-249-7940
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Fax | 218-249-7949
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Provider Business Mailing Address
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Address Line | 1012 E 2ND ST
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City | DULUTH
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State | MN
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Zip | 55805-2200
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Country | US
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Telephone | 218-249-7940
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Fax | 218-249-7949
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 127832
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | EMC0005005
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 45321
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License Number State | MN
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