Healthcare Provider Details

I. General information

NPI: 1841582038
Provider Name (Legal Business Name): STEPHEN P DUBIN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 MCLEOD DR STE 140-B
LAS VEGAS NV
89120-4442
US

IV. Provider business mailing address

5915 S RAINBOW BLVD STE 100
LAS VEGAS NV
89118-2558
US

V. Phone/Fax

Practice location:
  • Phone: 702-736-2999
  • Fax: 702-736-2199
Mailing address:
  • Phone: 702-362-9930
  • Fax: 702-362-9954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS STEPHEN P DUBIN
Title or Position: BUSINESS MGR
Credential: MD
Phone: 702-362-9930