MEDICARE: SIMI S VANCISE 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	207R00000X	Internal Medicine Physician	13467	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1841251469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMI S VANCISE MD

Provider Business Mailing Address
First Line	:	2200 PASEO VERDE PKWY STE 260
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-2703
Country	:	US
Telephone Number	:	702-616-5801
Fax Number	:	702-304-5935

Provider Business Practice Location Address
First Line	:	8689 W CHARLESTON BLVD STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5485
Country	:	US
Telephone Number	:	702-616-5801
Fax Number	:

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	10/17/2017

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Directions to “ SIMI S VANCISE MD” Practice Location

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