Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 6819 | NV |
NPI | 1043201031 |
---|---|
Provider Name | Dr. David J Oliveri |
First Address | Las Vegas, NV 89137-0183 |
Second Address | Las Vegas, NV 89145-4882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 24/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002019331 | (05) | NV |
F01894 | (02) | NV |