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General NPI Number Information
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NPI Number | 1558188003
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Entity Type | Organization
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Legal Business Name | IMMERSIVE MEDICAL HOLDINGS PLLC
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Dates
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Enumeration Date | 09/25/2024
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 2359 CLIFFWOOD DR
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City | HENDERSON
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State | NV
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Zip | 89074-5874
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Country | US
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Telephone | 702-408-7855
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Fax |
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Provider Business Mailing Address
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Address Line | 732 S 6TH ST STE R
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City | LAS VEGAS
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State | NV
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Zip | 89101-6948
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Country | US
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Telephone | 602-703-7813
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JESSE SHRIKI
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Credential | D. O.
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Telephone | 602-703-7813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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