MEDICARE: ENDER ANESTHESIOLOGY, P.C.

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	207L00000X	Anesthesiology Physician	1205	NV

General Provider Information

NPI Number	:	1487942496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDER ANESTHESIOLOGY, P.C.

Provider Business Mailing Address
First Line	:	1930 VILLAGE CENTER CIR
Second Line	:	BOX 3-395
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6299
Country	:	US
Telephone Number	:	702-449-4284
Fax Number	:	702-247-1225

Provider Business Practice Location Address
First Line	:	1930 VILLAGE CENTER CIR
Second Line	:	BOX 3-395
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6299
Country	:	US
Telephone Number	:	702-449-4284
Fax Number	:	702-247-1225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY IIRWIN ENDER
Credential	:	D.O.
Telephone Number	:	702-247-1221

Provider Enumeration Date	:	07/12/2011
Last Update Date	:	07/12/2011

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