Healthcare Provider Details

I. General information

NPI: 1326185984
Provider Name (Legal Business Name): RICHARD NEAL WULFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233 W. CHARLESTON BLVD STE 101
LAS VEGAS NV
89102-1923
US

IV. Provider business mailing address

3233 W. CHARLESTON BLVD STE 101
LAS VEGAS NV
89102-1923
US

V. Phone/Fax

Practice location:
  • Phone: 702-388-1008
  • Fax: 702-410-8451
Mailing address:
  • Phone: 702-388-1008
  • Fax: 702-410-8451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number8180
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: