Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 496 | NV |
NPI | 1124028337 |
---|---|
Provider Name | Scott Edward Manthei |
First Address | Las Vegas, NV 89120-7237 |
Second Address | Las Vegas, NV 89120-7237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 14/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1124028337 | (05) | NV |