Provider Demographics
NPI:1922107788
Name:NWAPA, EMMANUEL (MD)
Entity Type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:
Last Name:NWAPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EMMANUEL
Other - Middle Name:
Other - Last Name:NWAPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10120 W FLAMINGO RD STE 597
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8392
Mailing Address - Country:US
Mailing Address - Phone:702-854-5000
Mailing Address - Fax:702-929-2011
Practice Address - Street 1:601 S RANCHO DR STE D32
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4827
Practice Address - Country:US
Practice Address - Phone:702-854-5000
Practice Address - Fax:702-929-2011
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV107302084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100504994Medicaid
NVI39299Medicare UPIN
NV100504994Medicaid