Healthcare Provider Details

I. General information

NPI: 1053303560
Provider Name (Legal Business Name): WALTER J EHRMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: WALTER J EHRMAN MD

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 07/26/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N BUFFALO DR STE 100
LAS VEGAS NV
89145-0397
US

IV. Provider business mailing address

700 E SILVERADO RANCH BLVD STE 170
LAS VEGAS NV
89183-7518
US

V. Phone/Fax

Practice location:
  • Phone: 702-240-6482
  • Fax:
Mailing address:
  • Phone: 702-240-6482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA69981
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number15855
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: