Basic Information
| Provider Information | |||||||||
| NPI: | 1104054311 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NETTO | ||||||||
| FirstName: | ANUJ | ||||||||
| MiddleName: | PETER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 61 WHITCHER ST NE | ||||||||
| Address2: | SUITE 1100 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300601176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704223290 | ||||||||
| FaxNumber: | 7704220287 | ||||||||
| Practice Location | |||||||||
| Address1: | 2222 E HIGHLAND AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022776211 | ||||||||
| FaxNumber: | 8668468709 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2009 | ||||||||
| LastUpdateDate: | 08/26/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | A131563 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 073874 | GA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 58654 | AZ | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 003168746C | 05 | GA | MEDICAID | 003168746D | 05 | GA | MEDICAID | P01735733 | 01 | GA | MEDICARE RAILROAD | OTHER | 003168746B | 05 | GA | MEDICAID |