Individual
RUSSELL N NEIBAUR
Active
Individual
RUSSELL N NEIBAUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5228
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11041321
CAQH
—
01
—
5228
LICENSE
NV
01
—
CS03683
PHARMACY
NV
Enumeration date
02/09/2006
Last updated
07/30/2024
Update your record
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