Individual
MRS. MIRIAM S BETTENCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6170 N DURANGO DR STE 140, LAS VEGAS, NV 89149-3926
(702) 430-5333
Mailing address
9097 W POST RD STE 100, LAS VEGAS, NV 89148-2417
(702) 430-5333
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
10084
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018117
—
NV
Enumeration date
07/16/2006
Last updated
01/19/2023
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