Healthcare Provider Details

I. General information

NPI: 1598181828
Provider Name (Legal Business Name): MATTHEW HAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6170 N DURANGO DR STE 140
LAS VEGAS NV
89149-3926
US

IV. Provider business mailing address

6170 N DURANGO DR STE 140
LAS VEGAS NV
89149-3926
US

V. Phone/Fax

Practice location:
  • Phone: 702-430-5333
  • Fax:
Mailing address:
  • Phone: 702-430-5333
  • Fax: 702-430-5335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number64641
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number64641
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number21353
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateUT
# 5
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number21353
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: