Provider Demographics
NPI:1841582038
Name:STEPHEN P DUBIN MD INC
Entity Type:Organization
Organization Name:STEPHEN P DUBIN MD INC
Other - Org Name:STEPHEN P DUBIN MD INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BUSINESS MGR
Authorized Official - Prefix:MISS
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-362-9930
Mailing Address - Street 1:5915 S RAINBOW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2558
Mailing Address - Country:US
Mailing Address - Phone:702-362-9930
Mailing Address - Fax:702-362-9954
Practice Address - Street 1:6230 MCLEOD DR
Practice Address - Street 2:STE 140-B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4442
Practice Address - Country:US
Practice Address - Phone:702-736-2999
Practice Address - Fax:702-736-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-06
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty