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NPI Code Detail

MEDICARE: SELWYN KIDNEY MD LTD

MEDICARE: SELWYN KIDNEY MD LTD
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
1174400000XSpecialist6065NV

Other Identifiers

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

General Provider Information

NPI Number : 1932382314
Entity Type Code : Organization
Provider Name (Legal Business Name) : SELWYN KIDNEY MD LTD
Provider Business Mailing Address
First Line : PO BOX 93358
Second Line :
City : LAS VEGAS
State : NV
Zip : 89193-3358
Country : US
Telephone Number : 702-487-6510
Fax Number : 702-405-7960
Provider Business Practice Location Address
First Line : 3153 E WARM SPRINGS
Second Line : 300
City : LAS VEGAS
State : NV
Zip : 89120-3143
Country : US
Telephone Number : 702-487-6510
Fax Number : 702-405-7960
Authorized Official
Title or Position : CEO
Name : DR. SELWYN KIDNEY
Credential : MD
Telephone Number : 702-487-6510
Provider Enumeration Date : 12/09/2007
Last Update Date : 01/21/2015

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