| Yakov D Shaposhnikov Md, Pc | |
|
2020 Wellness Way Suite 406 Las Vegas NV 89106-4000 | |
| (702) 737-3337 | |
| (702) 737-3965 |
| Full Name | Yakov D Shaposhnikov Md, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2020 Wellness Way, Las Vegas, Nevada |
| Authorized Official Name and Position | Yakov Shaposhnikov (OWNER) |
| Authorized Official Contact | 7027373337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yakov D Shaposhnikov Md, Pc 8617 Robinson Ridge Dr Las Vegas NV 89117-5807 Ph: (702) 737-3337 | Yakov D Shaposhnikov Md, Pc 2020 Wellness Way Suite 406 Las Vegas NV 89106-4000 Ph: (702) 737-3337 |
| NPI Number | 1053655969 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 5496907685 |
|---|---|
| Medicare Enrollment ID | O20121217000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053655969 | NPI | - | NPPES |
| 002019051 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 8002 (Nevada) | Primary |
| Provider Name | Yakov D Shaposhnikov |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790710994 PECOS PAC ID: 9638167240 Enrollment ID: I20040503001536 |
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