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NPI Code Detail

MEDICARE: MSSD LLC

MEDICARE: MSSD LLC
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
1261Q00000XClinic/Center
2363A00000XPhysician Assistant
3208D00000XGeneral Practice Physician
4208M00000XHospitalist Physician
5207R00000XInternal Medicine Physician
6207Q00000XFamily Medicine Physician
7207P00000XEmergency Medicine Physician
8208000000XPediatrics Physician
9363L00000XNurse Practitioner

General Provider Information

NPI Number : 1316353089
Entity Type Code : Organization
Provider Name (Legal Business Name) : MSSD LLC
Provider Business Mailing Address
First Line : 6280 S VALLEY VIEW BLVD
Second Line : SUITE 721
City : LAS VEGAS
State : NV
Zip : 89118-3809
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6280 S VALLEY VIEW BLVD
Second Line : SUITE 721
City : LAS VEGAS
State : NV
Zip : 89118-3809
Country : US
Telephone Number : 888-225-0588
Fax Number : 702-529-0256
Authorized Official
Title or Position : MANAGER
Name : PATRICK BENEDICTO
Credential :
Telephone Number : 888-225-0588
Provider Enumeration Date : 07/02/2014
Last Update Date : 07/08/2014

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Directions to “MSSD LLC ” Practice Location

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