Doctor Name: | DR. NATHAN CECAVA |
NPI Number: | 1235194168 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 01056531A |
Business Practice Address: | 4700 Las Vegas Blvd N 99 Msgs Nellis Afb, NV - 891916600 |
Business Phone Number: | 7026532830 |
Business Fax Number: | |
Mailing Address: | 12137 Capilla Real Ave, LAS VEGAS |
State: | NV |
Postal Code: | 891384542 |
Phone Number: | 2107222542 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2006 |
NPI Last Update Date: | 07/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01056531A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |