Provider Demographics
NPI:1659337459
Name:KOZMARY, STEVEN V (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:V
Last Name:KOZMARY
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 1:2851 EL CAMINO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4266
Mailing Address - Country:US
Mailing Address - Phone:702-380-3210
Mailing Address - Fax:702-380-3212
Practice Address - Street 1:2851 EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4266
Practice Address - Country:US
Practice Address - Phone:702-380-3210
Practice Address - Fax:702-380-3212
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5695208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002438Medicaid
NV002002438Medicaid
NVV30441Medicare ID - Type Unspecified