Provider Demographics
NPI:1326287806
Name:SHALEV, AMIR (DPM)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:SHALEV
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6935 ALIANTE PKWY STE 104-227
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-5818
Mailing Address - Country:US
Mailing Address - Phone:702-248-3668
Mailing Address - Fax:888-863-8533
Practice Address - Street 1:2701 N TENAYA WAY STE 230
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0480
Practice Address - Country:US
Practice Address - Phone:702-248-3668
Practice Address - Fax:702-256-0387
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV0304213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVB54992Medicare PIN
NVU95585Medicare UPIN