Provider Demographics
NPI:1760417950
Name:BATTAGLIA, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:BATTAGLIA
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 1:9260 W SUNSET RD
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4903
Mailing Address - Country:US
Mailing Address - Phone:808-263-5184
Mailing Address - Fax:808-262-2387
Practice Address - Street 1:640 ULUKAHIKI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4454
Practice Address - Country:US
Practice Address - Phone:808-263-5184
Practice Address - Fax:808-262-2387
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73848207L00000X
HI14752207L00000X
NV16764207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology