Healthcare Provider Details

I. General information

NPI: 1477660603
Provider Name (Legal Business Name): MELVIN IRWIN POHL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 N BUFFALO DRIVE SUITE 125
LAS VEGAS NV
89129
US

IV. Provider business mailing address

3321 N BUFFALO DRIVE SUITE 200
LAS VEGAS NV
89129
US

V. Phone/Fax

Practice location:
  • Phone: 702-868-5800
  • Fax: 702-331-3098
Mailing address:
  • Phone: 702-515-1373
  • Fax: 702-256-9245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number3712
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: