| Executive Health And Wellness Center | |
|
8463 W Lake Mead Blvd Las Vegas NV 89128-7638 | |
| (702) 304-0854 | |
| (702) 256-2821 |
| Full Name | Executive Health And Wellness Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 8463 W Lake Mead Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Robert White (OWNER) |
| Authorized Official Contact | 7023040854 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Health And Wellness Center 8463 W Lake Mead Blvd Las Vegas NV 89128-7638 Ph: (702) 304-0854 | Executive Health And Wellness Center 8463 W Lake Mead Blvd Las Vegas NV 89128-7638 Ph: (702) 304-0854 |
| NPI Number | 1801998307 |
|---|---|
| Provider Enumeration Date | 09/04/2006 |
| Last Update Date | 05/16/2014 |
| Medicare PECOS PAC ID | 0648271668 |
|---|---|
| Medicare Enrollment ID | O20070118000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801998307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 6089 (Nevada) | Primary |
| Provider Name | Robert K White |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740208834 PECOS PAC ID: 1355339896 Enrollment ID: I20070118000096 |
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