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NPI Code Detail

MEDICARE: MAVERICK JOSEPH CHAMBERS

MEDICARE:   MAVERICK JOSEPH CHAMBERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide1405468121NV

General Provider Information

NPI Number : 1023769445
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAVERICK JOSEPH CHAMBERS
Provider Business Mailing Address
First Line : 6300 W LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-6443
Country : US
Telephone Number : 725-724-5388
Fax Number :
Provider Business Practice Location Address
First Line : 6300 W LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-6443
Country : US
Telephone Number : 725-724-5388
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2022
Last Update Date : 01/18/2022

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Directions to “ MAVERICK JOSEPH CHAMBERS ” Practice Location

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