Provider Demographics
NPI:1457345845
Name:ROSLER, HANS-JORG W (MD)
Entity Type:Individual
Prefix:DR
First Name:HANS-JORG
Middle Name:W
Last Name:ROSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 S RAMPART BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4883
Mailing Address - Country:US
Mailing Address - Phone:702-357-8004
Mailing Address - Fax:702-357-8005
Practice Address - Street 1:851 S RAMPART BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-4883
Practice Address - Country:US
Practice Address - Phone:702-357-8004
Practice Address - Fax:702-357-8005
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2015-01-13
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
NV10364174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018830Medicaid
NV002018830Medicaid