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NPI Code Detail

MEDICARE: MATTHEW EHRICH STOFFERAHN M.D.

MEDICARE: MATTHEW EHRICH STOFFERAHN M.D.
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
1207P00000XEmergency Medicine PhysicianC7-0003761DE
2207R00000XInternal Medicine PhysicianC7-0003761DE
3207P00000XEmergency Medicine Physician14194NV

General Provider Information

NPI Number : 1215139258
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW EHRICH STOFFERAHN M.D.
Provider Business Mailing Address
First Line : 500 N RAINBOW BLVD STE 203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1084
Country : US
Telephone Number : 702-259-1228
Fax Number :
Provider Business Practice Location Address
First Line : 500 N RAINBOW BLVD STE 203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1084
Country : US
Telephone Number : 702-259-1228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2007
Last Update Date : 06/22/2012

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