Healthcare Provider Details
I. General information
NPI: 1316704489
Provider Name (Legal Business Name): VIKTOR KUNDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/05/2024
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4700 LAS VEGAS BLVD N
NELLIS AFB NV
89191-6600
US
IV. Provider business mailing address
4700 LAS VEGAS BLVD N
NELLIS AFB NV
89191-6600
US
V. Phone/Fax
- Phone: 702-653-2273
- Fax:
- Phone: 702-653-2273
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083A0100X |
| Taxonomy | Aerospace Medicine Physician |
| License Number | 0102209461 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 0102209461 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: