MEDICARE: DANA FORTE D O LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363AM0700X	Medical Physician Assistant
3	363LF0000X	Family Nurse Practitioner
4	207Q00000X	Family Medicine Physician

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	:	1649209420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANA FORTE D O LTD

Provider Business Mailing Address
First Line	:	9010 W CHEYENNE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8932
Country	:	US
Telephone Number	:	702-240-8646
Fax Number	:	702-240-0206

Provider Business Practice Location Address
First Line	:	9010 W CHEYENNE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8932
Country	:	US
Telephone Number	:	702-240-8646
Fax Number	:	702-240-0206

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANA M FORTE
Credential	:	DO
Telephone Number	:	702-240-8646

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	03/28/2023

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Directions to “DANA FORTE D O LTD ” Practice Location

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