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General NPI Number Information
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NPI Number | 1568505295
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Entity Type | Organization
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Legal Business Name | MARK C HANDELMAN MD LTD
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 2585 BOX CANYON DR SUITE 110
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City | LAS VEGAS
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State | NV
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Zip | 89128-0429
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Country | US
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Telephone | 702-538-7773
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Fax | 702-256-9035
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Provider Business Mailing Address
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Address Line | 2585 BOX CANYON DR SUITE 110
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City | LAS VEGAS
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State | NV
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Zip | 89128-0429
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Country | US
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Telephone | 702-538-7773
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Fax | 702-256-9035
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Authorized Official
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Title or Position | OWNER
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Name | MARK C HANDELMAN
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Credential | MD
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Telephone | 702-538-7773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 6880
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License Number State | NV
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