Healthcare Provider Details

I. General information

NPI: 1063675874
Provider Name (Legal Business Name): ALLEN ROBERT ANES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 ANTHEM POINTE CT
HENDERSON NV
89052-6605
US

IV. Provider business mailing address

20 ANTHEM POINTE COURT
HENDERSON NV
89052-6605
US

V. Phone/Fax

Practice location:
  • Phone: 702-458-6454
  • Fax: 702-458-3838
Mailing address:
  • Phone: 702-458-6454
  • Fax: 702-458-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberG46901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: