MEDICARE: SKIN CHECK SUMMERLIN LLC

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	207N00000X	Dermatology Physician		NV

General Provider Information

NPI Number	:	1164514931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKIN CHECK SUMMERLIN LLC

Provider Business Mailing Address
First Line	:	9416 DEL WEBB BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144
Country	:	US
Telephone Number	:	702-450-7546
Fax Number	:	702-360-3990

Provider Business Practice Location Address
First Line	:	9416 DEL WEBB BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-8314
Country	:	US
Telephone Number	:	702-450-7546
Fax Number	:	702-360-3990

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. MATTHEW W HEMSTREET
Credential	:	M.D.
Telephone Number	:	702-450-7546

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	08/22/2020

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Directions to “SKIN CHECK SUMMERLIN LLC ” Practice Location

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