Healthcare Provider Details

I. General information

NPI: 1346306016
Provider Name (Legal Business Name): NIKOLAOS TOUROUTOGLOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 N TENAYA WAY STE 201
LAS VEGAS NV
89128
US

IV. Provider business mailing address

PO BOX 98978
LAS VEGAS NV
89193-8978
US

V. Phone/Fax

Practice location:
  • Phone: 702-735-7154
  • Fax: 702-869-8103
Mailing address:
  • Phone: 702-216-3346
  • Fax: 702-671-6883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number7839
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: