Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 44505 | WI |
Y | 207VE0102X | Reproductive Endocrinologist | 7453 | NV |
NPI | 1013066125 |
---|---|
Provider Name | Mark F Severino |
First Address | Las Vegas, NV 89118-1986 |
Second Address | Las Vegas, NV 89118-1986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 28/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34243800 | (05) | WI |
E71538 | (02) |