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Individual

MICHAEL CHILDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2316 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2149
(702) 877-8600
(702) 240-8790
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 240-8847
(702) 240-8790

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
75904
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2102020
NV
01
480032403
RAILROAD MEDICARE
NV
Enumeration date
02/14/2006
Last updated
12/22/2021
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