Provider Demographics
NPI:1932851482
Name:DABU, NATHANIEL PAULE (PA-C)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:PAULE
Last Name:DABU
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7423 BECKINSALE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-6210
Mailing Address - Country:US
Mailing Address - Phone:702-274-7379
Mailing Address - Fax:
Practice Address - Street 1:6125 W TROPICANA AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4654
Practice Address - Country:US
Practice Address - Phone:702-701-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant