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NPI Code Detail

MEDICARE: DIRECT MD NEVADA LLC

MEDICARE: DIRECT MD NEVADA 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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1285519199
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIRECT MD NEVADA LLC
Provider Business Mailing Address
First Line : 9510 W SAHARA AVE STE 225
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-8812
Country : US
Telephone Number : 702-843-1353
Fax Number :
Provider Business Practice Location Address
First Line : 9510 W SAHARA AVE STE 225
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-8812
Country : US
Telephone Number : 702-843-1353
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : TRAVIS WINWARD
Credential :
Telephone Number : 208-740-9076
Provider Enumeration Date : 08/08/2025
Last Update Date : 08/08/2025

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Directions to “DIRECT MD NEVADA LLC ” Practice Location

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