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General NPI Number Information
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NPI Number | 1376956631
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Entity Type | Individual
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Provider Name | DREW JOSEPH IMAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 2231 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-2254
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Country | US
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Telephone | 702-383-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 2231 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-2254
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Country | US
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Telephone | 702-383-2663
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 5101021030
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | OS16167
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | DO3258
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License Number State | NV
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