Healthcare Provider Details

I. General information

NPI: 1588664437
Provider Name (Legal Business Name): MICHAEL GERARD SCHEIDLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 W CHARLESTON BLVD STE 110
LAS VEGAS NV
89102-2352
US

IV. Provider business mailing address

1707 W CHARLESTON BLVD STE 110
LAS VEGAS NV
89102-2352
US

V. Phone/Fax

Practice location:
  • Phone: 702-650-2500
  • Fax: 702-650-2220
Mailing address:
  • Phone: 702-650-2500
  • Fax: 702-650-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number10936
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: