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General NPI Number Information
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NPI Number | 1881136760
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Entity Type | Organization
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Legal Business Name | EVA SNOW MD LLC
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 1815 E LAKE MEAD BLVD STE 314
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-7193
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Country | US
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Telephone | 702-227-0022
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Fax | 702-227-0084
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Provider Business Mailing Address
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Address Line | PO BOX 27135
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City | LAS VEGAS
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State | NV
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Zip | 89126-1135
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Country | US
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Telephone | 702-227-0022
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Fax | 702-227-0084
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. EVANGELINA U SNOW
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Credential | MD
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Telephone | 702-227-0022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9875
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License Number State | NV
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