Provider Demographics
NPI:1245400472
Name:SOPHY WEI FENG MD
Entity Type:Organization
Organization Name:SOPHY WEI FENG MD
Other - Org Name:ANTHEM OBGYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOPHY
Authorized Official - Middle Name:WEI
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-433-5357
Mailing Address - Street 1:10624 S EASTERN AVE # A-258
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2982
Mailing Address - Country:US
Mailing Address - Phone:702-433-5357
Mailing Address - Fax:702-433-1238
Practice Address - Street 1:2405 W HORIZON RIDGE PKWY # 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2649
Practice Address - Country:US
Practice Address - Phone:702-433-5357
Practice Address - Fax:702-433-1238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV164780207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101192OtherMEDICARE GROUP
NV141620Medicare UPIN
NVV101193Medicare PIN