| Omer H Wharton-ali Md A Professional Corporation | |
|
1703 Civic Center Dr #1b N Las Vegas NV 89030-7273 | |
| (702) 399-3404 | |
| (702) 399-1819 |
| Full Name | Omer H Wharton-ali Md A Professional Corporation |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1703 Civic Center Dr #1b, N Las Vegas, Nevada |
| Authorized Official Name and Position | Omer H Wharton-ali (PRESIDENT) |
| Authorized Official Contact | 7023993404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omer H Wharton-ali Md A Professional Corporation Po Box 364479 N Las Vegas NV 89036-8479 Ph: (702) 399-3404 | Omer H Wharton-ali Md A Professional Corporation 1703 Civic Center Dr #1b N Las Vegas NV 89030-7273 Ph: (702) 399-3404 |
| NPI Number | 1912992983 |
|---|---|
| Provider Enumeration Date | 09/15/2005 |
| Last Update Date | 01/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912992983 | NPI | - | NPPES |
| 002002260 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 3863 (Nevada) | Primary |
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