MEDICARE: MICHAEL OMOREGIE AIGBE 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
1	174400000X	Specialist	9506	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	:	1962451047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL OMOREGIE AIGBE M.D.

Provider Business Mailing Address
First Line	:	7271 W SAHARA AVE
Second Line	:	STE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2862
Country	:	US
Telephone Number	:	702-639-1700
Fax Number	:	702-639-1717

Provider Business Practice Location Address
First Line	:	3201 S MARYLAND PKWY
Second Line	:	SUITE 606
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2441
Country	:	US
Telephone Number	:	702-639-1700
Fax Number	:	702-639-1717

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	10/31/2016

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