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NPI Code Detail

MEDICARE: ELLIOT RUNGE DO

MEDICARE: ELLIOT RUNGE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease PhysicianDO3911NV
2207RC0200XCritical Care Medicine (Internal Medicine) PhysicianDO3911NV
3207R00000XInternal Medicine Physician0102206478VA

General Provider Information

NPI Number : 1043779325
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIOT RUNGE DO
Provider Business Mailing Address
First Line : 4700 LAS VEGAS BLVD N
Second Line :
City : NELLIS AFB
State : NV
Zip : 89191-6600
Country : US
Telephone Number : 702-653-2273
Fax Number :
Provider Business Practice Location Address
First Line : 4700 LAS VEGAS BLVD N
Second Line :
City : NELLIS AFB
State : NV
Zip : 89191-6600
Country : US
Telephone Number : 702-653-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2019
Last Update Date : 06/09/2026

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Directions to “ ELLIOT RUNGE DO” Practice Location

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