Provider Demographics
NPI:1639669567
Name:ROY, NERVIK (DO)
Entity Type:Individual
Prefix:DR
First Name:NERVIK
Middle Name:
Last Name:ROY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 MOUNT MARIAH DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-1506
Mailing Address - Country:US
Mailing Address - Phone:702-851-7766
Mailing Address - Fax:702-851-7760
Practice Address - Street 1:1581 MOUNT MARIAH DR STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-1506
Practice Address - Country:US
Practice Address - Phone:702-851-7766
Practice Address - Fax:702-851-7760
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSL1342207R00000X
NVDO2871208D00000X
COTL.0008760390200000X
NVDO3366207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program