Provider Demographics
NPI:1124019591
Name:TAPPER, EDWARD M (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:M
Last Name:TAPPER
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 1:973 MICA DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89705-7255
Mailing Address - Country:US
Mailing Address - Phone:775-783-6190
Mailing Address - Fax:775-783-6191
Practice Address - Street 1:1520 VIRGINIA RANCH RD
Practice Address - Street 2:SUITE 101B
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5731
Practice Address - Country:US
Practice Address - Phone:775-782-2442
Practice Address - Fax:775-783-6199
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC29083207X00000X
NV3279207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C290830OtherMEDI-CAL
NVCC6621OtherBCBS
NV2003061Medicaid
NVP00722837OtherMEDICARE RAILROAD
NVVMD3279Medicare PIN
A33832Medicare UPIN
NV2003061Medicaid