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Individual

DR. VANESSA GREEN GASTWIRTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3150 N TENAYA WAY SUITE 460, LAS VEGAS, NV 89128
(702) 233-1000
(702) 233-1001
Mailing address
3150 N TENAYA WAY SUITE 460, LAS VEGAS, NV 89128
(702) 233-1000
(702) 233-1001

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
13801
NV
207RC0000X
Cardiovascular Disease Physician
35471
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102142
AZ
01
2009239 9965156
TRICARE
AZ
01
P00413309
RAILROAD MEDICARE
AZ
Enumeration date
05/04/2006
Last updated
03/31/2021
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