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General NPI Number Information
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NPI Number | 1275152522
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Entity Type | Organization
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Legal Business Name | MARTINMD, MAVROIDISMD, DHUDSHIAMD, & FEIKESMD, CARDIOVASCULAR SURGICAL
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 7488 W SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89117-2740
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Country | US
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Telephone | 702-737-3808
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 S RAINBOW BLVD STE 282
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City | LAS VEGAS
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State | NV
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Zip | 89118-1896
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Country | US
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Telephone | 702-737-3808
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Fax | 702-737-7364
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | JENNA HALL
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Credential |
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Telephone | 702-719-8952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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