Provider Demographics
NPI: | 1376559989 |
---|---|
Name: | DEL ROSARIO, ARTHUR D (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | ARTHUR |
Middle Name: | D |
Last Name: | DEL ROSARIO |
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: | 4230 BURNHAM AVENUE |
Mailing Address - Street 2: | |
Mailing Address - City: | LAS VEGAS |
Mailing Address - State: | NV |
Mailing Address - Zip Code: | 89119 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 702-733-7866 |
Mailing Address - Fax: | 702-733-8862 |
Practice Address - Street 1: | 4230 BURNHAM AVE |
Practice Address - Street 2: | |
Practice Address - City: | LAS VEGAS |
Practice Address - State: | NV |
Practice Address - Zip Code: | 89119 |
Practice Address - Country: | US |
Practice Address - Phone: | 702-733-7866 |
Practice Address - Fax: | 702-733-8862 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-08-01 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NV | 9459 | 207ZC0500X, 207ZP0102X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Not Answered | 207ZC0500X | Allopathic & Osteopathic Physicians | Pathology | Cytopathology |
Not Answered | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
34593 | Medicare ID - Type Unspecified | ||
G04184 | Medicare UPIN |