Healthcare Provider Details

I. General information

NPI: 1295292084
Provider Name (Legal Business Name): IMS NEUROSURGICAL SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 CORONADO CENTER DR STE 200
HENDERSON NV
89052-3992
US

IV. Provider business mailing address

10105 BANBURRY CROSS DR STE 445
LAS VEGAS NV
89144-6645
US

V. Phone/Fax

Practice location:
  • Phone: 702-475-8454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCHNEIER
Title or Position: PRESIDENT
Credential: MD
Phone: 310-404-5117