Healthcare Provider Details

I. General information

NPI: 1578687661
Provider Name (Legal Business Name): ROGER WEIBAR HSIUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 S. DURANGO SUITE #105
LAS VEGAS NV
89113
US

IV. Provider business mailing address

6080 S. DURANGO SUITE #105
LAS VEGAS NV
89113
US

V. Phone/Fax

Practice location:
  • Phone: 702-586-6688
  • Fax: 702-586-9988
Mailing address:
  • Phone: 702-586-6688
  • Fax: 702-586-9988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberLL1438
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: