Provider Demographics
NPI:1790896074
Name:SIBEL, ROMAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:A
Last Name:SIBEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10624 S EASTERN AVE
Mailing Address - Street 2:SUITE A-963
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2982
Mailing Address - Country:US
Mailing Address - Phone:702-997-9833
Mailing Address - Fax:702-666-0413
Practice Address - Street 1:3175 SAINT ROSE PKWY
Practice Address - Street 2:SUITE 320
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3500
Practice Address - Country:US
Practice Address - Phone:702-997-9833
Practice Address - Fax:702-666-0413
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-09-17
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Provider Licenses
StateLicense IDTaxonomies
NV11987207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVI61442Medicare UPIN