MEDICARE: SHER INSTITUTE FOR REPRODUCTIVE MEDICINE LAS VEGAS MEDICAL GROUP PC

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	207VE0102X	Reproductive Endocrinology Physician	9113	NV
2	207V00000X	Obstetrics & Gynecology Physician	9113	NV

General Provider Information

NPI Number	:	1881805679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHER INSTITUTE FOR REPRODUCTIVE MEDICINE LAS VEGAS MEDICAL GROUP PC

Provider Business Mailing Address
First Line	:	5320 S RAINBOW BLVD
Second Line	:	SUITE 300
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2307
Country	:	US
Telephone Number	:	702-794-0073
Fax Number	:	702-696-0554

Provider Business Practice Location Address
First Line	:	5320 S RAINBOW BLVD
Second Line	:	SUITE 300
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1840
Country	:	US
Telephone Number	:	702-794-0073
Fax Number	:	702-696-0554

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. JEFFREY FISCH
Credential	:	MD
Telephone Number	:	702-794-0073

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/02/2008

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