Healthcare Provider Details

I. General information

NPI: 1457898868
Provider Name (Legal Business Name): FERTILITY CENTER OF LAS VEGAS SHAPIRO MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 01/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 W SAHARA AVE STE 100
LAS VEGAS NV
89117-5865
US

IV. Provider business mailing address

8851 W SAHARA AVE STE 100
LAS VEGAS NV
89117-5865
US

V. Phone/Fax

Practice location:
  • Phone: 702-254-1777
  • Fax: 702-228-2678
Mailing address:
  • Phone: 702-254-1777
  • Fax: 702-228-2678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number5710
License Number StateNV

VIII. Authorized Official

Name: BRUCE S SHAPIRO
Title or Position: MANAGER
Credential: MD
Phone: 702-254-1777