MEDICARE: STELJES CARDIOLOGY PC

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	207RC0000X	Cardiovascular Disease Physician	6360	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	:	1366652513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STELJES CARDIOLOGY PC

Provider Business Mailing Address
First Line	:	2839 SAINT ROSE PKWY
Second Line	:	SUITE 160
City	:	HENDERSON
State	:	NV
Zip	:	89052-4848
Country	:	US
Telephone Number	:	702-492-1450
Fax Number	:	702-492-1978

Provider Business Practice Location Address
First Line	:	2839 SAINT ROSE PKWY
Second Line	:	SUITE 160
City	:	HENDERSON
State	:	NV
Zip	:	89052-4848
Country	:	US
Telephone Number	:	702-492-1450
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT OF CO.
Name	:	ALAN DAVID STELJES
Credential	:	M.D.
Telephone Number	:	702-492-1450

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/02/2014

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