Provider Demographics
NPI:1679623276
Name:DANKA K MICHAELS M D PROF CORP
Entity Type:Organization
Organization Name:DANKA K MICHAELS M D PROF CORP
Other - Org Name:BLUEPOINT MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING, CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WANAMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-869-6190
Mailing Address - Street 1:3320 N BUFFALO DR
Mailing Address - Street 2:STE. 106
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7443
Mailing Address - Country:US
Mailing Address - Phone:702-869-6190
Mailing Address - Fax:702-869-6199
Practice Address - Street 1:3320 N BUFFALO DR
Practice Address - Street 2:STE. 106
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7443
Practice Address - Country:US
Practice Address - Phone:702-869-6190
Practice Address - Fax:702-869-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG34625Medicare UPIN
NVV38009Medicare PIN