MEDICARE: MICHAEL O NYARKO 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	208000000X	Pediatrics Physician	8819	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	:	1477532372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL O NYARKO MD

Provider Business Mailing Address
First Line	:	10105 BANBURRY CROSS DR
Second Line	:	SUITE 370
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-6646
Country	:	US
Telephone Number	:	702-260-4525
Fax Number	:	702-869-0133

Provider Business Practice Location Address
First Line	:	10105 BANBURRY CROSS DR
Second Line	:	SUITE 370
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-6646
Country	:	US
Telephone Number	:	702-260-4525
Fax Number	:	702-869-0133

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	09/27/2013

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Directions to “ MICHAEL O NYARKO MD” Practice Location

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