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NPI Code Detail

MEDICARE: DR. NOEL R FAJARDO M.D.

MEDICARE:  DR. NOEL R FAJARDO  M.D.
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
1207RG0100XGastroenterology Physician44964MN
2207RG0100XGastroenterology Physician12053NV

Other Identifiers

General Provider Information

NPI Number : 1255305520
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NOEL R FAJARDO M.D.
Provider Business Mailing Address
First Line : 7315 S. PECOS ROAD
Second Line : STE. 101
City : LAS VEGAS
State : NV
Zip : 89120
Country : US
Telephone Number : 702-982-7240
Fax Number : 702-952-5444
Provider Business Practice Location Address
First Line : 3901 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7537
Country : US
Telephone Number : 702-982-7240
Fax Number : 702-952-5444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 05/30/2024

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Directions to “ DR. NOEL R FAJARDO M.D.” Practice Location

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