MEDICARE: DR. NICHOLAS JOHN VERNETTI 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
1	207R00000X	Internal Medicine Physician	57011540	OH
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	15680	NV

General Provider Information

NPI Number	:	1407939317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS JOHN VERNETTI M.D.

Provider Business Mailing Address
First Line	:	9280 W SUNSET RD
Second Line	:	SUITE 306
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4860
Country	:	US
Telephone Number	:	702-696-7256
Fax Number	:	702-796-7256

Provider Business Practice Location Address
First Line	:	9280 W SUNSET RD
Second Line	:	SUITE 306
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4860
Country	:	US
Telephone Number	:	702-696-7256
Fax Number	:	702-796-7256

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/20/2015

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