University of Nevada School of Medicine Multi-Spec Grp Pract So

NPI #1013316165 in Las Vegas, Nevada

Provider Information

NPI Number: 1013316165
Entity Type: Organization
Organization Name: University of Nevada School of Medicine Multi-Spec Grp Pract So
Primary Specialty: Internal Medicine
Enumeration Date: Aug 14, 2014
Last Updated: Aug 14, 2014

Practice Location

Address: 2231 W CHARLESTON BLVD
Address 2: 1ST FLOOR
City: Las Vegas
State: Nevada
ZIP Code: 89102-2254
Phone: (702) 676-3650

Authorized Official

Name: MRS. JOANNE HANSEN
Title: CREDENTIALING SPECIALIST
Phone: (702) 671-2395

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X
Internal Medicine	207R00000X	Primary

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