Individual
RUSSELL N NEIBAUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2450 W HORIZON RIDGE PKWY STE 150, HENDERSON, NV 89052-2722
(702) 990-0622
(702) 938-1473
Mailing address
2450 W HORIZON RIDGE PKWY STE 150, HENDERSON, NV 89052-2722
(702) 990-0622
(702) 938-1473
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
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