Provider Demographics
NPI:1750348645
Name:ENGEL, STUART ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:ALLEN
Last Name:ENGEL
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 1:5380 S RAINBOW BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1877
Mailing Address - Country:US
Mailing Address - Phone:702-379-4753
Mailing Address - Fax:702-367-8207
Practice Address - Street 1:5380 S RAINBOW BLVD
Practice Address - Street 2:STE 300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118
Practice Address - Country:US
Practice Address - Phone:702-379-4753
Practice Address - Fax:702-367-8207
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1497208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500032Medicaid
D87259Medicare UPIN
NV38035Medicare ID - Type Unspecified