Individual
DR. EMELITA DEMETILLO LIWANAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1835 ODDIE BLVD, SPARKS, NV 89431-3559
(775) 982-5140
(775) 982-5141
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13024
NV
207Q00000X
Family Medicine Physician
L.2736R
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11985918
CAQH
—
05
—
1275708182
—
NV
Enumeration date
04/23/2008
Last updated
08/31/2017
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