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NPI Code Detail

MEDICARE: THOMAS SAMUEL ROBEN DO

MEDICARE: THOMAS SAMUEL ROBEN 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
1207R00000XInternal Medicine Physician862NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00853280OTHERNVRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1862OTHERNVSTATE LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841292315
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS SAMUEL ROBEN DO
Provider Business Mailing Address
First Line : 6355 S BUFFALO DR FL 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2133
Country : US
Telephone Number : 702-216-3346
Fax Number : 702-671-6883
Provider Business Practice Location Address
First Line : 9499 W CHARLESTON BLVD
Second Line : #150
City : LAS VEGAS
State : NV
Zip : 89117-7150
Country : US
Telephone Number : 702-228-5477
Fax Number : 702-671-6883
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 10/19/2022

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Directions to “ THOMAS SAMUEL ROBEN DO” Practice Location

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