Provider Demographics
NPI:1295985729
Name:RYAN J. GRABOW, MD, LTD
Entity type:Organization
Organization Name:RYAN J. GRABOW, MD, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRABOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-433-9533
Mailing Address - Street 1:PO BOX 531162
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89053-1162
Mailing Address - Country:US
Mailing Address - Phone:702-433-9533
Mailing Address - Fax:702-478-5492
Practice Address - Street 1:3175 SAINT ROSE PKWY
Practice Address - Street 2:SUITE 330
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3506
Practice Address - Country:US
Practice Address - Phone:702-433-9533
Practice Address - Fax:702-478-5492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11886207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV161099Medicare UPIN
NV161099Medicare UPIN