Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 8690 | NV |
NPI | 1144286238 |
---|---|
Provider Name | Mr. Stephen M Wold |
First Address | Las Vegas, NV 89106 |
Second Address | Las Vegas, NV 89106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 28/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2018058 | (05) | NV |
G25793 | (02) |