Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 1301 | NV |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101011091 | MI |
NPI | 1265411516 |
---|---|
Provider Name | Susan E Schwartz |
First Address | Las Vegas, NV 89128-7640 |
Second Address | Henderson, NV 89074-7163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2006 |
Last Update Date | 04/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100510939 | (05) | NV |
G36369 | (02) | NV |