Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 7950 | NV |
NPI | 1063594315 |
---|---|
Provider Name | Gary Michael Flangas |
First Address | Las Vegas, NV 89113-2236 |
Second Address | Las Vegas, NV 89113-2236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 01/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002002964 | (05) | NV |
H10788 | (02) |