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NPI Code Detail

MEDICARE: GRANITE SURGERY CENTER

MEDICARE: GRANITE SURGERY CENTER
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
1261QA0006XAmbulatory Fertility Facility5710NV

General Provider Information

NPI Number : 1467793182
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANITE SURGERY CENTER
Provider Business Mailing Address
First Line : 8851 W SAHARA AVE STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-5865
Country : US
Telephone Number : 702-254-1197
Fax Number : 702-228-2678
Provider Business Practice Location Address
First Line : 8851 W SAHARA AVE STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-5865
Country : US
Telephone Number : 702-254-1197
Fax Number : 702-228-2678
Authorized Official
Title or Position : PARTNER
Name : DR. BRUCE SHAPIRO
Credential : MD PHD
Telephone Number : 702-254-1197
Provider Enumeration Date : 03/05/2013
Last Update Date : 03/05/2013

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Directions to “GRANITE SURGERY CENTER ” Practice Location

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