Provider Demographics
NPI:1053643080
Name:JORAM S SEGGEV MD CHARTERED
Entity Type:Organization
Organization Name:JORAM S SEGGEV MD CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:SEGGEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-822-2444
Mailing Address - Street 1:7500 W LAKE MEAD BLVD # C9-292
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0297
Mailing Address - Country:US
Mailing Address - Phone:702-822-2444
Mailing Address - Fax:702-242-0655
Practice Address - Street 1:7500 W LAKE MEAD BLVD # C9-292
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0297
Practice Address - Country:US
Practice Address - Phone:702-822-2444
Practice Address - Fax:702-242-0655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV34604Medicare PIN