Individual
LAUREN ELAINE MAXHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2845 SIENA HEIGHTS DR, HENDERSON, NV 89052-4153
(702) 617-1227
(702) 492-9574
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 617-1227
(702) 492-9574
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15412
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326347154
SMA MEDICAID
NV
01
—
V110872
SMA MEDICARE
NV
01
—
VWQBHV
GROUP MEDICARE
NV
Enumeration date
03/18/2011
Last updated
01/17/2017
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