Provider Demographics
NPI:1578656237
Name:HURWITZ, S ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:S
Middle Name:ROBERT
Last Name:HURWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:
Other - Last Name:HURWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3560 E FLAMINGO RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-0201
Mailing Address - Country:US
Mailing Address - Phone:702-433-6100
Mailing Address - Fax:702-433-9489
Practice Address - Street 1:3560 E FLAMINGO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-0201
Practice Address - Country:US
Practice Address - Phone:702-433-6100
Practice Address - Fax:702-433-9489
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG211432085R0202X
NV120862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G211430Medicaid
CA1578656237OtherNPI
NV100511572Medicaid
A4115Medicare UPIN
CA00G211430Medicaid
NV103441Medicare PIN
NV103440Medicare PIN
NVV103441Medicare PIN
NVP00376171Medicare PIN