=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730174061
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GERALD MARK SYLVAIN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2005
-----------------------------------------------------
Last Update Date | 11/10/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2231 WEST CHARLESTON BLVD.
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-383-2663
-----------------------------------------------------
Fax | 702-383-2682
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1800 W. CHARLESTON BLVD.
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-383-2000
-----------------------------------------------------
Fax | 702-522-1781
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 8092
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------