Healthcare Provider Details

I. General information

NPI: 1003367921
Provider Name (Legal Business Name): CHARLIE Y. NAHM, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6053 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5577
US

IV. Provider business mailing address

6053 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5577
US

V. Phone/Fax

Practice location:
  • Phone: 702-968-6259
  • Fax: 702-987-3219
Mailing address:
  • Phone: 702-968-6259
  • Fax: 702-987-3219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLIE NAHM
Title or Position: OWNER
Credential: MD
Phone: 702-968-6259