Individual
ANDREI ANDROSSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5230 BOULDER HWY STE 110, LAS VEGAS, NV 89122
(702) 940-1560
(702) 940-1561
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17795
NV
207Q00000X
Family Medicine Physician
ME121765
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063610061
—
NV
01
—
17795
STATE LICENSE
NV
Enumeration date
07/11/2007
Last updated
10/14/2022
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