Individual
KENNETH EJIKEME IZUORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1707 W CHARLESTON BLVD STE 290, LAS VEGAS, NV 89102-2353
(702) 671-5070
(702) 671-5198
Mailing address
3016 W CHARLESTON BLVD STE 100, LAS VEGAS, NV 89102-1973
(702) 780-7118
(702) 671-6430
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
061267
GA
207R00000X
Internal Medicine Physician
50418-020
WI
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
13512
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100500484GROUP
—
NV
Enumeration date
01/10/2007
Last updated
05/28/2020
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