| Summerlin Functional Medicine | |
|
8811 W Sahara Ave Ste 200 Las Vegas NV 89117-4813 | |
| (702) 333-2627 | |
| Not Available |
| Full Name | Summerlin Functional Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 8811 W Sahara Ave Ste 200, Las Vegas, Nevada |
| Authorized Official Name and Position | John M Bowman (PRESIDENT) |
| Authorized Official Contact | 7023332627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summerlin Functional Medicine 9101 W Sahara Ave Las Vegas NV 89117-5772 Ph: () - | Summerlin Functional Medicine 8811 W Sahara Ave Ste 200 Las Vegas NV 89117-4813 Ph: (702) 333-2627 |
| NPI Number | 1275034621 |
|---|---|
| Provider Enumeration Date | 02/21/2018 |
| Last Update Date | 04/17/2018 |
| Medicare PECOS PAC ID | 4486917853 |
|---|---|
| Medicare Enrollment ID | O20180417002448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275034621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | John Michael Bowman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760423370 PECOS PAC ID: 8820088321 Enrollment ID: I20180918001550 |
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