Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 466 | NV |
NPI | 1083636369 |
---|---|
Provider Name | Dr. James Del Rosso |
First Address | Las Vegas, NV 89148-2417 |
Second Address | Las Vegas, NV 89148-2417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070010708 | RAILROAD MEDICARE (01) | NV |
D60674 | (02) | |
P00813972 | RR MEDICARE (01) | NV |