Provider Demographics
NPI:1346306016
Name:TOUROUTOGLOU, NIKOLAOS (MD)
Entity Type:Individual
Prefix:
First Name:NIKOLAOS
Middle Name:
Last Name:TOUROUTOGLOU
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:PO BOX 98978
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8978
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:2650 N TENAYA WAY STE 201
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128
Practice Address - Country:US
Practice Address - Phone:702-735-7154
Practice Address - Fax:702-869-8103
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7839207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0020019580Medicaid
NV002019580Medicaid
NV002019850Medicaid
NVPENDINGMedicaid
NV002019850Medicaid
NVPENDINGMedicaid
NV1233510002Medicare NSC
NVPENDINGMedicare PIN