Individual
TAMRA BALDAUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2020 PALOMINO LN STE 100, LAS VEGAS, NV 89106-4894
(702) 759-8600
(702) 384-1815
Mailing address
2020 PALOMINO LN STE 100, LAS VEGAS, NV 89106-4894
(702) 759-8600
(702) 384-1815
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
8976
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326099268
—
NV
01
—
152967
WC
NV
01
—
153087
WC
NV
05
—
200290107
—
NV
01
—
300101536
RR MEDICARE
NV
01
—
7850
BCBS
NV
Enumeration date
05/15/2006
Last updated
03/17/2018
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