Provider Demographics
NPI:1043494842
Name:FIRST CARE FAMILY MEDICINE SHOLEFF
Entity Type:Organization
Organization Name:FIRST CARE FAMILY MEDICINE SHOLEFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHOLEFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-233-8855
Mailing Address - Street 1:1700 N BUFFALO DR
Mailing Address - Street 2:100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-2676
Mailing Address - Country:US
Mailing Address - Phone:702-233-8855
Mailing Address - Fax:702-921-6828
Practice Address - Street 1:1700 N BUFFALO DR
Practice Address - Street 2:100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-2676
Practice Address - Country:US
Practice Address - Phone:702-233-8855
Practice Address - Fax:702-921-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVH19043Medicare UPIN