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General NPI Number Information
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NPI Number | 1982872834
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Entity Type | Organization
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Legal Business Name | CARL DEMARDRIAN VIRGIL MD PC MOUNTAIN ANESTHESIA COUNSULTANTS
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 3153 E WARM SPRINGS #300
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City | LAS VEGAS
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State | NV
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Zip | 89120
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Country | US
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Telephone | 702-487-6510
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Fax | 702-405-7960
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Provider Business Mailing Address
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Address Line | 3153 E WARM SPRINGS #300
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City | LAS VEGAS
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State | NV
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Zip | 89120
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Country | US
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Telephone | 702-487-6510
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Fax | 702-405-7960
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Authorized Official
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Title or Position | CEO
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Name | CARL D VIRGIL
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Credential | MD
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Telephone | 702-487-6510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 8069
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License Number State | NV
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