Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 11764 | NV |
NPI | 1104841824 |
---|---|
Provider Name | Robert C Rollins |
First Address | Las Vegas, NV 89109 |
Second Address | Las Vegas, NV 89109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100510383 | (05) | NV |
CC5761 | BLUE CROSS BLUE SHIELD (01) | |
XPY205005 | MEDI-CAL (01) |