Provider Demographics
NPI:1114262185
Name:VISITING MEDICAL SPECIALISTS OF NEVADA, INC
Entity Type:Organization
Organization Name:VISITING MEDICAL SPECIALISTS OF NEVADA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:NPC
Authorized Official - Phone:419-699-1907
Mailing Address - Street 1:2718 CENTENNIAL RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1829
Mailing Address - Country:US
Mailing Address - Phone:419-517-8858
Mailing Address - Fax:
Practice Address - Street 1:871 CORONADO CENTER DR
Practice Address - Street 2:SUITE 260
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3977
Practice Address - Country:US
Practice Address - Phone:702-952-2861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14254207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty