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General NPI Number Information
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NPI Number | 1346579984
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Entity Type | Individual
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Provider Name | TREVOR RUSSELL CALDWELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/10/2009
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 6900 N PECOS RD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-4400
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Country | US
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Telephone | 702-791-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 11025 RCA CENTER DR STE 300
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4269
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Country | US
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Telephone | 561-383-3820
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Fax | 855-369-2450
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ML60093443
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 54516
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 17136
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MT198717
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License Number State | PA
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