Provider Demographics
NPI:1417098567
Name:CREMONINI, FILIPPO (MD)
Entity Type:Individual
Prefix:DR
First Name:FILIPPO
Middle Name:
Last Name:CREMONINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7315 S. PECOS ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120
Mailing Address - Country:US
Mailing Address - Phone:702-982-7240
Mailing Address - Fax:702-586-7506
Practice Address - Street 1:3910 S MARYLAND PKWY
Practice Address - Street 2:SUITE 9B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7570
Practice Address - Country:US
Practice Address - Phone:702-982-7240
Practice Address - Fax:702-586-7506
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN49957207R00000X
MA246157207RG0100X
NV14135207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN161960000Medicaid
MN161960000Medicaid