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NPI Code Detail

MEDICARE: DR. MARTHA KNUTSEN M.D.

MEDICARE: DR. MARTHA KNUTSEN 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
12080N0001XNeonatal-Perinatal Medicine Physician8232NV

General Provider Information

NPI Number : 1306808241
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARTHA KNUTSEN M.D.
Provider Business Mailing Address
First Line : 4100 MANSION HALL CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-3665
Country : US
Telephone Number : 702-869-5258
Fax Number :
Provider Business Practice Location Address
First Line : 620 SHADOW LN
Second Line : VALLEY HOSPITAL
City : LAS VEGAS
State : NV
Zip : 89106-4119
Country : US
Telephone Number : 702-671-8550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 12/31/2008

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