Provider Demographics
NPI:1730119827
Name:TENBY, MICHAEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:TENBY
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 1:6850 N. DURANGO DR.
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149
Mailing Address - Country:US
Mailing Address - Phone:702-897-6000
Mailing Address - Fax:702-897-6062
Practice Address - Street 1:6850 N. DURANGO DR.
Practice Address - Street 2:SUITE 306
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149
Practice Address - Country:US
Practice Address - Phone:702-897-6000
Practice Address - Fax:702-897-6062
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10483208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics