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General NPI Number Information
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NPI Number | 1164156790
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Entity Type | Organization
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Legal Business Name | HUMMINGBIRD MEDICAL GROUP
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 5550 PAINTED MIRAGE RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89149-4581
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Country | US
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Telephone | 725-204-1474
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Fax | 725-500-5049
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Provider Business Mailing Address
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Address Line | 5550 PAINTED MIRAGE RD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89149-4581
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Country | US
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Telephone | 725-204-1474
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Fax | 725-500-5049
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Authorized Official
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Title or Position | COO
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Name | ELIZABETH ENSING
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Credential |
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Telephone | 616-745-4091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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