MEDICARE: DR. DMYTRO BOND MD

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
1	208000000X	Pediatrics Physician	9546	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164482147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DMYTRO BOND MD

Provider Business Mailing Address
First Line	:	5751 S FORT APACHE RD
Second Line	:	SUITE A
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-939-0480
Fax Number	:	702-939-0482

Provider Business Practice Location Address
First Line	:	5751 S FORT APACHE RD
Second Line	:	SUITE A
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5624
Country	:	US
Telephone Number	:	702-939-0480
Fax Number	:	702-939-0482

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	10/17/2012

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Directions to “ DR. DMYTRO BOND MD” Practice Location

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