MEDICARE: MARK C HANDELMAN MD LTD

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	261Q00000X	Clinic/Center	6880	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	V103413	OTHER	NV	MEDICARE ID- UNSPECIFIED

General Provider Information

NPI Number	:	1568505295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK C HANDELMAN MD LTD

Provider Business Mailing Address
First Line	:	2585 BOX CANYON DR
Second Line	:	SUITE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0429
Country	:	US
Telephone Number	:	702-538-7773
Fax Number	:	702-256-9035

Provider Business Practice Location Address
First Line	:	2585 BOX CANYON DR
Second Line	:	SUITE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0429
Country	:	US
Telephone Number	:	702-538-7773
Fax Number	:	702-256-9035

Authorized Official
Title or Position	:	OWNER
Name	:	MARK C HANDELMAN
Credential	:	MD
Telephone Number	:	702-538-7773

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	08/13/2013

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