Provider Demographics
NPI:1205990413
Name:FLEISHER, CHARLES W (MD)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:W
Last Name:FLEISHER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:100 N GREEN VALLEY PKWY
Mailing Address - Street 2:STE 345
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7705
Mailing Address - Country:US
Mailing Address - Phone:702-260-0600
Mailing Address - Fax:702-260-4444
Practice Address - Street 1:100 N GREEN VALLEY PKWY
Practice Address - Street 2:STE 345
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7055
Practice Address - Country:US
Practice Address - Phone:702-260-0600
Practice Address - Fax:702-260-4444
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV8351207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2002971Medicaid
NVV35130Medicare PIN
NV2002971Medicaid