Theodore Potruch MD Ltd a Professional Corporation

NPI #1659389989 in Las Vegas, Nevada

Provider Information

NPI Number: 1659389989
Entity Type: Organization
Organization Name: Theodore Potruch MD Ltd a Professional Corporation
Primary Specialty: Surgery
Enumeration Date: Aug 3, 2006
Last Updated: Mar 6, 2018

Practice Location

Address: 2020 GOLDRING AVE
Address 2: PRACTICE CLOSED
City: Las Vegas
State: Nevada
ZIP Code: 89106-4000
Phone: (702) 000-0000

Authorized Official

Name: THEODORE POTRUCH, MD
Title: PRESIDENT
Phone: (702) 000-0000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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