Provider Demographics
NPI:1033385307
Name:NAHM, CHARLIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLIE
Middle Name:
Last Name:NAHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9333 W SUNSET RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4845
Mailing Address - Country:US
Mailing Address - Phone:702-968-6259
Mailing Address - Fax:702-987-3219
Practice Address - Street 1:9333 W SUNSET RD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4845
Practice Address - Country:US
Practice Address - Phone:702-968-6259
Practice Address - Fax:702-987-3219
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70052207LP2900X
NV16636207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH08364Medicare UPIN