Provider Demographics
NPI:1750311957
Name:PATTI, ROBERT WAYNE (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WAYNE
Last Name:PATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2080 E FLAMINGO
Mailing Address - Street 2:#301
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119
Mailing Address - Country:US
Mailing Address - Phone:702-734-8876
Mailing Address - Fax:702-734-9456
Practice Address - Street 1:2080 E FLAMINGO
Practice Address - Street 2:#301
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-734-8876
Practice Address - Fax:702-734-9456
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5172207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C01119Medicare UPIN
341344779Medicare ID - Type Unspecified