MEDICARE: WILLIAM DAVID ALONSO ARIAS

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
1	207L00000X	Anesthesiology Physician	16233	NV

General Provider Information

NPI Number	:	1275822702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM DAVID ALONSO ARIAS

Provider Business Mailing Address
First Line	:	2136 E DESERT INN RD STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3247
Country	:	US
Telephone Number	:	917-684-8221
Fax Number	:

Provider Business Practice Location Address
First Line	:	2136 E DESERT INN RD STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3247
Country	:	US
Telephone Number	:	917-684-8221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2011
Last Update Date	:	02/02/2016

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