MEDICARE: DR. ZIDRIECK PARDUCHO VALDES 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
1	207R00000X	Internal Medicine Physician	8355	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851339360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZIDRIECK PARDUCHO VALDES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 26145
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89126-0145
Country	:	US
Telephone Number	:	702-877-8808
Fax Number	:	702-877-8889

Provider Business Practice Location Address
First Line	:	1019 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3920
Country	:	US
Telephone Number	:	702-877-8808
Fax Number	:	702-877-8889

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

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	05/25/2010

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