Provider Demographics
NPI:1356501217
Name:G MARK SYLVAIN MD CHTD
Entity Type:Organization
Organization Name:G MARK SYLVAIN MD CHTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:SYLVAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-388-1008
Mailing Address - Street 1:1050 RANCHO CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-4623
Mailing Address - Country:US
Mailing Address - Phone:702-388-1008
Mailing Address - Fax:
Practice Address - Street 1:701 S TONOPAH DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4030
Practice Address - Country:US
Practice Address - Phone:702-388-1008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV8092207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWQVCQMedicare UPIN