Provider Demographics
NPI:1518448042
Name:ANDREIA R POP MD PC
Entity Type:Organization
Organization Name:ANDREIA R POP MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:POP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-219-8969
Mailing Address - Street 1:4790 CAUGHLIN PKWY # 176
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-0907
Mailing Address - Country:US
Mailing Address - Phone:775-219-8969
Mailing Address - Fax:
Practice Address - Street 1:2375 E PRATER WAY FL 7
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434
Practice Address - Country:US
Practice Address - Phone:775-219-8969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherIRS EIN