Nydam, Robert Gregory

Nydam, Robert Gregory is an individual health care provider with primary practice located at 888 S Rancho Dr , Las Vegas NV 89106-3810. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Independent Duty Medical Technicians, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Nydam, Robert Gregory can be contacted via phone (702) 877-8600.

Contact Information

Primary practice address
888 S Rancho Dr Las Vegas NV 89106-3810
Phone: (702) 877-8600
Fax: (702) 258-6152
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Medical Technicians 1710I1003X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Nevada

Profile Details

NPI number 1184867301
LBN Legal business name Nydam, Robert Gregory
Credentials IDMT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2009
Last updated Jan 23rd, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184867301 NPPES
Nevada MEDICAID 1184867301

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