Provider Demographics
NPI:1093718751
Name:ALBREGTS, ANTHONY E (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:E
Last Name:ALBREGTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANTHONY
Other - Middle Name:E
Other - Last Name:ALBREGTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3950 G.S. RICHARDS BLVD.
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-8457
Mailing Address - Country:US
Mailing Address - Phone:775-324-0699
Mailing Address - Fax:777-888-8067
Practice Address - Street 1:640 W MOANA LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4997
Practice Address - Country:US
Practice Address - Phone:775-336-3624
Practice Address - Fax:775-888-8067
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7811207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV30623Medicare ID - Type Unspecified
NVF90864Medicare UPIN