Healthcare Provider Details

I. General information

NPI: 1497739601
Provider Name (Legal Business Name): HOWARD I BARON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3196 S MARYLAND PKWY SUITE 309
LAS VEGAS NV
89109-2314
US

IV. Provider business mailing address

3196 S MARYLAND PKWY SUITE 309
LAS VEGAS NV
89109-2314
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-0477
  • Fax: 702-791-6831
Mailing address:
  • Phone: 702-791-0477
  • Fax: 702-791-6831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number6739
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: