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NPI Code Detail

MEDICARE: MARC T WASHINGTON RPA-C

MEDICARE: MARC T WASHINGTON RPA-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
1363A00000XPhysician Assistant015798NY
2363A00000XPhysician AssistantPA1728NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689926693
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC T WASHINGTON RPA-C
Provider Business Mailing Address
First Line : 2345 E. PRATER WAY, SUITE 207
Second Line :
City : SPARKS
State : NV
Zip : 89434
Country : US
Telephone Number : 775-356-9393
Fax Number : 775-356-5590
Provider Business Practice Location Address
First Line : 3802 MEADOWS LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-3112
Country : US
Telephone Number : 702-313-8446
Fax Number : 702-221-8446
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2012
Last Update Date : 09/28/2017

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Directions to “ MARC T WASHINGTON RPA-C” Practice Location

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