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General NPI Number Information
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NPI Number | 1144490343
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF NEVADA SCHOOL OF MEDICINE MULTI-SPECIALTY GROUP PRACTICE
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 10/14/2015
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Provider Practice Location Address
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Address Line | 901 RANCHO LN 205
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City | LAS VEGAS
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State | NV
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Zip | 89106-3836
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Country | US
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Telephone | 702-944-2810
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Fax | 702-944-2820
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Provider Business Mailing Address
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Address Line | PO BOX 29506
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City | LAS VEGAS
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State | NV
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Zip | 89126-9506
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Country | US
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Telephone | 702-968-4371
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Fax | 702-671-5170
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELISSA J PALMER
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Credential | MD
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Telephone | 702-992-6888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number |
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number |
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License Number State | NV
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