Provider Demographics
NPI:1902839475
Name:PAIVA, ROSE ELIZABETH (MD)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:ELIZABETH
Last Name:PAIVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6542 S MCCARRAN BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6167
Mailing Address - Country:US
Mailing Address - Phone:775-329-3484
Mailing Address - Fax:775-329-5362
Practice Address - Street 1:6542 S MCCARRAN BLVD STE B
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6142
Practice Address - Country:US
Practice Address - Phone:775-329-3484
Practice Address - Fax:775-329-5362
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1174708879OtherNPI
NV1174708879OtherNPI
NVG79816Medicare UPIN
NVV32351Medicare PIN
NVV105788Medicare PIN