Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 11817 | NV |
N | 207ND0101X | MOHS-Micrographic Surgeon | 11817 | NV |
N | 207ND0900X | Dermatopathologist | 11817 | NV |
N | 207NP0225X | Pediatric Dermatologist | 11817 | NV |
N | 207NS0135X | Procedural Dermatology | 11817 | NV |
N | 207R00000X | Internist | 11817 | NV |
N | 111NI0900X | Internist | 11817 | NV |
NPI | 1447276175 |
---|---|
Provider Name | Harry Greenberg |
First Address | Las Vegas, NV 89144-0514 |
Second Address | Las Vegas, NV 89144-0514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 07/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1730375262 | 2-ORGANIZATION NPI (01) | NV |
H91983 | (02) |