MEDICARE: ROBERT W PATTI MD CHTD

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	174400000X	Specialist	5172	NV

General Provider Information

NPI Number	:	1629398649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT W PATTI MD CHTD

Provider Business Mailing Address
First Line	:	2080 E FLAMINGO RD
Second Line	:	SUITE 301
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5164
Country	:	US
Telephone Number	:	702-734-8876
Fax Number	:	702-734-9456

Provider Business Practice Location Address
First Line	:	2080 E FLAMINGO RD
Second Line	:	SUITE 301
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5164
Country	:	US
Telephone Number	:	702-734-8876
Fax Number	:	702-734-9456

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT WAYNE PATTI
Credential	:	MD
Telephone Number	:	702-734-8876

Provider Enumeration Date	:	06/02/2010
Last Update Date	:	08/03/2010

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