MEDICARE: CHARLES D MCPHERSON 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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	5810	NV
2	207RP1001X	Pulmonary Disease Physician	5810	NV
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	5810	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316996721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES D MCPHERSON MD

Provider Business Mailing Address
First Line	:	9280 WEST SUNSET RD
Second Line	:	STE 312
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-737-5864
Fax Number	:	702-737-6885

Provider Business Practice Location Address
First Line	:	3121 SOUTH MARYLAND PKWY
Second Line	:	STE 502
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-731-9306
Fax Number	:	702-737-9781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	03/08/2010

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Directions to “ CHARLES D MCPHERSON MD” Practice Location

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