Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 3712 | NV |
NPI | 1477660603 |
---|---|
Provider Name | Melvin Irwin Pohl |
First Address | Las Vegas, NV 89129 |
Second Address | Las Vegas, NV 89129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 09/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2019174 | (05) | NV |
E57635 | (02) | NV |