Provider Demographics
NPI:1962199109
Name:MUSCELLI, SPENCER PERRY (MD)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:PERRY
Last Name:MUSCELLI
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 1:325 AMBER PINE ST APT 206
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-4218
Mailing Address - Country:US
Mailing Address - Phone:702-763-1617
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD # MS 3010
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8501
Practice Address - Country:US
Practice Address - Phone:913-588-6739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program