Provider Demographics
NPI:1326185984
Name:WULFF, RICHARD NEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NEAL
Last Name:WULFF
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 1:3233 W. CHARLESTON BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1923
Mailing Address - Country:US
Mailing Address - Phone:702-388-1008
Mailing Address - Fax:702-410-8451
Practice Address - Street 1:3233 W. CHARLESTON BLVD
Practice Address - Street 2:STE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1923
Practice Address - Country:US
Practice Address - Phone:702-388-1008
Practice Address - Fax:702-410-8451
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8180207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2002630Medicaid
NV002002630Medicaid
NV2002630Medicaid
NVV36127Medicare PIN