Provider Demographics
NPI:1336200112
Name:FENG, SOPHY WEI (MD)
Entity Type:Individual
Prefix:DR
First Name:SOPHY
Middle Name:WEI
Last Name:FENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10624 S EASTERN AVE.
Mailing Address - Street 2:#A258
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052
Mailing Address - Country:US
Mailing Address - Phone:702-433-5357
Mailing Address - Fax:702-433-1238
Practice Address - Street 1:2405 W HORIZON RIDGE PKWY
Practice Address - Street 2:#100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2649
Practice Address - Country:US
Practice Address - Phone:702-433-5357
Practice Address - Fax:702-433-1238
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV164780207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101192OtherMEDICARE GROUP
I41620Medicare UPIN
NVV101193Medicare PIN