=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124019591
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EDWARD M TAPPER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2005
-----------------------------------------------------
Last Update Date | 10/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1520 VIRGINIA RANCH RD SUITE 101B
-----------------------------------------------------
City | GARDNERVILLE
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89410-5731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-782-2442
-----------------------------------------------------
Fax | 775-783-6199
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 973 MICA DR SUITE 201
-----------------------------------------------------
City | CARSON CITY
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89705-7255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-783-6190
-----------------------------------------------------
Fax | 775-783-6191
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | C29083
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 3279
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------