Potruch, Theodore

Potruch, Theodore is an individual health care provider with primary practice located at 2123 Civic Center Dr , North Las Vegas NV 89030-6327. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Potruch, Theodore can be contacted via phone (702) 333-1110.

Contact Information

Primary practice address
2123 Civic Center Dr North Las Vegas NV 89030-6327
Phone: (702) 333-1110
Fax: (702) 685-0744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 3310 Nevada

Profile Details

NPI number 1649225293
LBN Legal business name Potruch, Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Mar 6th, 2018 - about 8 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 1649225293 NPPES
Nevada Other V50306 MEDICARE PTAN

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