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General NPI Number Information
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NPI Number | 1720335177
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Entity Type | Individual
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Provider Name | MICHAEL SHAMIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2012
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Last Update Date | 07/25/2018
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Provider Practice Location Address
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Address Line | 2020 PALOMINO LN STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89106
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Country | US
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Telephone | 702-759-8600
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Fax | 702-384-1815
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Provider Business Mailing Address
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Address Line | PO BOX 636256
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City | CINCINNATI
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State | OH
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Zip | 45263-6256
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Country | US
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Telephone | 513-245-3600
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Fax | 513-245-3672
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35130234
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 17590
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License Number State | NV
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