Provider Demographics
NPI:1649730433
Name:MIGLIAZZO, JOSEPH ANTHONY
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:MIGLIAZZO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:KS
Mailing Address - Zip Code:66208-1901
Mailing Address - Country:US
Mailing Address - Phone:816-721-0783
Mailing Address - Fax:
Practice Address - Street 1:915 S WOLFE ST APT 249
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-3649
Practice Address - Country:US
Practice Address - Phone:443-977-6803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD97292207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology