Provider Demographics
NPI:1104054311
Name:NETTO, ANUJ PETER (MD)
Entity type:Individual
Prefix:DR
First Name:ANUJ
Middle Name:PETER
Last Name:NETTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:61 WHITCHER ST NE
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1176
Mailing Address - Country:US
Mailing Address - Phone:770-422-3290
Mailing Address - Fax:770-422-0287
Practice Address - Street 1:2222 E HIGHLAND AVE STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4879
Practice Address - Country:US
Practice Address - Phone:602-277-6211
Practice Address - Fax:866-846-8709
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA131563207X00000X
GA073874207X00000X
AZ58654207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003168746CMedicaid
GA003168746DMedicaid
GAP01735733OtherMEDICARE RAILROAD
GA003168746BMedicaid
GA103I205245Medicare PIN