Roger Daniel
Individual provider Active NPI Contractor · Las Vegas, NV
NPI 1013468271 · NPPES record last updated Oct 21, 2016
Key facts
- NPI
- 1013468271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 2000236-044-101 (NV)
- Practice address
- 2500 Chandler Ave
Las Vegas, NV 89120-4004 - Phone
- (702) 405-6400
- NPI assigned
- Oct 21, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000236-044-101 | NV | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 2000236-044-101 | NV | Yes |
Addresses
Primary practice location
2500 Chandler Ave
Las Vegas, NV 89120-4004
Mailing address
2500 Chandler Ave
Las Vegas, NV 89120-4004
Phone (702) 405-6400
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.