Healthcare Provider Details

I. General information

NPI: 1912973041
Provider Name (Legal Business Name): MICHAEL J. GEHMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6070 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5615
US

IV. Provider business mailing address

6070 S FORT APACHE RD STE 100
LAS VEGAS NV
89148-5615
US

V. Phone/Fax

Practice location:
  • Phone: 702-803-5534
  • Fax: 888-977-1206
Mailing address:
  • Phone: 702-803-5534
  • Fax: 888-977-1206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number006611
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberOS008871L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number218797-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberDO3698
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: