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NPI Code Detail

MEDICARE: PETER W DEBRY M.D

MEDICARE: PETER W DEBRY 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
1207W00000XOphthalmology Physician10470NV

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 : 1831137991
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER W DEBRY M.D
Provider Business Mailing Address
First Line : 2390 W HORIZON RIDGE PKWY STE 100
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5084
Country : US
Telephone Number : 702-825-2085
Fax Number : 702-852-5743
Provider Business Practice Location Address
First Line : 2390 W HORIZON RIDGE PKWY STE 100
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5084
Country : US
Telephone Number : 702-825-2085
Fax Number : 702-852-5743
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 01/03/2024

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