Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 6762 | NV |
Y | 208600000X | Surgeon | 6762 | NV |
NPI | 1003872193 |
---|---|
Provider Name | Dr. Irwin B Simon |
First Address | Henderson, NV 89052-2721 |
Second Address | Henderson, NV 89052-2721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 13/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0002019607 | (05) | NV |
E29837 | (02) | NV |