Healthcare Provider Details

I. General information

NPI: 1104819770
Provider Name (Legal Business Name): RUDOLF ULIRSCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N PECOS RD
NORTH LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

6900 N PECOS RD
NORTH LAS VEGAS NV
89086-4400
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-9000
  • Fax:
Mailing address:
  • Phone: 702-791-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number139287
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number139287
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number139287
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: