Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 10281 | NV |
Y | 208600000X | Surgeon | 10281 | NV |
N | 2086S0102X | Surgical Critical Care | 10281 | NV |
N | 2086S0120X | Pediatric Surgery | 10281 | NV |
N | 2086S0127X | Trauma Surgeon | 10281 | NV |
N | 2086S0129X | Vascular Surgeon | 10281 | NV |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 10281 | NV |
NPI | 1649211749 |
---|---|
Provider Name | Martin A Bain |
First Address | Reno, NV 89502 |
Second Address | Reno, NV 89502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 14/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2016091 | (05) | NV |
H47437 | (02) | |
V36773 | (02) | NV |