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NPI Code Detail

MEDICARE: MATTHEW STEVEN GROLLE MD

MEDICARE: MATTHEW STEVEN GROLLE 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
1207V00000XObstetrics & Gynecology Physician14863NV

General Provider Information

NPI Number : 1245474204
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW STEVEN GROLLE MD
Provider Business Mailing Address
First Line : 8906 SPANISH RIDGE AVE STE 202
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1319
Country : US
Telephone Number : 702-330-3102
Fax Number : 702-912-4994
Provider Business Practice Location Address
First Line : 1950 PINTO LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4017
Country : US
Telephone Number : 702-438-2229
Fax Number : 702-385-0982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2009
Last Update Date : 01/15/2024

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Directions to “ MATTHEW STEVEN GROLLE MD” Practice Location

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