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Contact Information

UNIVERSITY OF NV SCHOOL OF MEDICINE MULTI-SPECIALTY GROUP PRACTICE SO
1707 W CHARLESTON BLVD
200
LAS VEGAS, NV89102-2351
 Phone: 702-671-6475
 Fax: 702-671-5090
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
 

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for UNIVERSITY OF NV SCHOOL OF MEDICINE MULTI SPECIALTY GROUP PRACTICE SO · (Female)

NPI # 1447576111
Status Active
Credentials
Entity Individual
Enumeration date 04/20/2010
Last updated 04/20/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • NV License # 12160
  • NV License # 7611
  • NV License # 7733
  • NV License # 9126
  • NV License # PY0320
  • NV License # PY320
  • NV Medicaid 100500484 GROUP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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