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NPI Code Detail

MEDICARE: PORTNEY MED GROUP

MEDICARE: PORTNEY MED GROUP
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
1207R00000XInternal Medicine Physician9534NV

General Provider Information

NPI Number : 1427364587
Entity Type Code : Organization
Provider Name (Legal Business Name) : PORTNEY MED GROUP
Provider Business Mailing Address
First Line : 5841 E CHARLESTON BLVD
Second Line : SUITE 457
City : LAS VEGAS
State : NV
Zip : 89142-1021
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5841 E CHARLESTON BLVD
Second Line : SUITE 457
City : LAS VEGAS
State : NV
Zip : 89142-1021
Country : US
Telephone Number : 702-418-5916
Fax Number :
Authorized Official
Title or Position : CEO
Name : ALEXANDER PORTNEY
Credential :
Telephone Number : 702-418-5916
Provider Enumeration Date : 08/27/2010
Last Update Date : 08/27/2010

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Directions to “PORTNEY MED GROUP ” Practice Location

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