MEDICARE: BRIAN P MCNALLY MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	25385	AZ
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	12964	NV

General Provider Information

NPI Number	:	1760459184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN P MCNALLY MD

Provider Business Mailing Address
First Line	:	7455 W WASHINGTON AVE
Second Line	:	STE 301
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-4340
Country	:	US
Telephone Number	:	702-732-3441
Fax Number	:	702-732-2310

Provider Business Practice Location Address
First Line	:	3059 S MARYLAND PKWY
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2294
Country	:	US
Telephone Number	:	702-732-3441
Fax Number	:	702-732-2310

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	05/03/2016

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Directions to “ BRIAN P MCNALLY MD” Practice Location

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