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General NPI Number Information
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NPI Number | 1487474300
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Entity Type | Organization
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Legal Business Name | MARK BURGER DO LLC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 10301 JEFFREYS ST
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City | HENDERSON
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State | NV
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Zip | 89052-3922
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Country | US
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Telephone | 702-939-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 10300 W CHARLESTON BLVD # 13-220
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City | LAS VEGAS
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State | NV
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Zip | 89135-1037
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Country | US
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Telephone | 702-625-1464
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARK BURGER
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Credential | DO
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Telephone | 702-625-1464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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