Provider Demographics
NPI:1740364918
Name:CASALMAN, STEPHANIE CAROL (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:CAROL
Last Name:CASALMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3150 N TENAYA WAY
Mailing Address - Street 2:#660
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0443
Mailing Address - Country:US
Mailing Address - Phone:702-648-6228
Mailing Address - Fax:702-648-9868
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:#660
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-648-6228
Practice Address - Fax:702-648-9868
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV1168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVH95342Medicare UPIN
NVV32709Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
NV39744Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER