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NPI Code Detail

MEDICARE: MARK J ADAIMY M.D.

MEDICARE: MARK J ADAIMY M.D.
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
1207RN0300XNephrology Physician10589NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659467769
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK J ADAIMY M.D.
Provider Business Mailing Address
First Line : 2820 W CHARLESTON BLVD STE 33
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1934
Country : US
Telephone Number : 702-880-1558
Fax Number : 702-870-6821
Provider Business Practice Location Address
First Line : 2820 W CHARLESTON BLVD STE 33
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1934
Country : US
Telephone Number : 702-880-1558
Fax Number : 702-870-6821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2020

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