Organization
MARTINMD, MAVROIDISMD, DHUDSHIAMD, & FEIKESMD, CARDIOVASCULAR SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNA HALL (CREDENTIALING SPECIALIST)
(702) 719-8952
Entity
Organization
Contact information
Practice address
7488 W SAHARA AVE, LAS VEGAS, NV 89117-2740
(702) 737-3808
Mailing address
5320 S RAINBOW BLVD STE 282, LAS VEGAS, NV 89118-1896
(702) 737-3808
(702) 737-7364
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100503336
—
NV
Enumeration date
04/15/2020
Last updated
04/15/2020
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