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General NPI Number Information
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NPI Number | 1770945768
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Entity Type | Individual
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Provider Name | ALVANCIN LOUIS MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 5225 S DURANGO DR
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City | LAS VEGAS
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State | NV
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Zip | 89113-0137
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Country | US
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Telephone | 702-240-6482
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Fax |
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Provider Business Mailing Address
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Address Line | 801 S RANCHO DR STE E6
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City | LAS VEGAS
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State | NV
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Zip | 89106-3812
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Country | US
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Telephone | 702-240-6482
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Fax |
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 036171472
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MW136647
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License Number State | FL
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