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Contact Information

PEDIATRIC GASTROENTEROLOGY PROF ASSN
3196 S MARYLAND PKWY STE 309
LAS VEGAS, NV89109-2314
 Phone: 702-791-0477
 Fax: 702-791-6831
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC GASTROENTEROLOGY PROF ASSN · (Female)

NPI Number 1912182890
Status Active
Credentials
Entity Individual
Enumeration date 01/09/2008
Last updated 08/15/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • NV License # 6739
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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