Provider Demographics
NPI:1679631014
Name:LEIBOWITZ, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:LEIBOWITZ
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 1:653 N TOWN CENTER DR STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-0515
Mailing Address - Country:US
Mailing Address - Phone:702-242-5555
Mailing Address - Fax:702-255-9308
Practice Address - Street 1:653 N TOWN CENTER DR STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0515
Practice Address - Country:US
Practice Address - Phone:702-242-5555
Practice Address - Fax:702-255-9308
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVP0702276J081992174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019256Medicaid
NV002019256Medicaid
NVA92361Medicare UPIN