Individual
MITCHELL FADOUL KEAMY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2850 S MOJAVE RD LOT A, LAS VEGAS, NV 89121
(702) 386-4700
(702) 386-4701
Mailing address
3157 N RAINBOW BLVD # 518, LAS VEGAS, NV 89108-4578
(702) 877-8661
(702) 877-5140
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5653
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504191
—
NV
01
—
P0169392
RAILROAD MEDICARE
NV
Enumeration date
07/20/2005
Last updated
08/27/2018
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