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NPI Code Detail

MEDICARE: VICTOR E. GRIGORIEV M.D.

MEDICARE: VICTOR E. GRIGORIEV 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
1208800000XUrology Physician7212NV
22088F0040XUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician7212NV

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 : 1720173602
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR E. GRIGORIEV M.D.
Provider Business Mailing Address
First Line : 7150 W SUNSET RD
Second Line : SUITE 201A
City : LAS VEGAS
State : NV
Zip : 89113-1981
Country : US
Telephone Number : 702-385-4342
Fax Number : 702-385-4346
Provider Business Practice Location Address
First Line : 7500 SMOKE RANCH RD.
Second Line : SUITE 200
City : LAS VEGAS
State : NV
Zip : 89128-0373
Country : US
Telephone Number : 702-233-0727
Fax Number : 702-233-4799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 07/17/2024

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Directions to “ VICTOR E. GRIGORIEV M.D.” Practice Location

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