Provider Demographics
NPI:1972787000
Name:FAKIEL, MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:FAKIEL
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 1:410 S RAMPART BLVD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5726
Mailing Address - Country:US
Mailing Address - Phone:702-326-1116
Mailing Address - Fax:702-726-6874
Practice Address - Street 1:410 S RAMPART BLVD
Practice Address - Street 2:SUITE 390
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5726
Practice Address - Country:US
Practice Address - Phone:702-326-1116
Practice Address - Fax:702-726-6874
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV80622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry