Provider Demographics
NPI:1982802260
Name:CINELLI, SCOTT M (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:M
Last Name:CINELLI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6554 S MCCARRAN BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6166
Mailing Address - Country:US
Mailing Address - Phone:775-324-0288
Mailing Address - Fax:775-323-5504
Practice Address - Street 1:6554 S MCCARRAN BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6166
Practice Address - Country:US
Practice Address - Phone:775-324-0288
Practice Address - Fax:775-323-5504
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1339208600000X, 2086S0127X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1982802260Medicaid
NVGD626ZMedicare PIN
NV1982802260Medicaid