Healthcare Provider Details

I. General information

NPI: 1194724237
Provider Name (Legal Business Name): SCOTT E MANTHEI PC LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2598 WINDMILL PKWY
HENDERSON NV
89074-5476
US

IV. Provider business mailing address

2598 WINDMILL PKWY
HENDERSON NV
89074-5476
US

V. Phone/Fax

Practice location:
  • Phone: 702-896-6043
  • Fax: 702-896-9591
Mailing address:
  • Phone: 702-896-6043
  • Fax: 702-896-9591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number StateNV

VIII. Authorized Official

Name: SCOTT E MANTHEI
Title or Position: OWNER / PRESIDENT
Credential: D.O.
Phone: 702-896-6043