Individual
MICHAEL ROOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1420 E CALVADA BLVD STE 100, PAHRUMP, NV 89048-3975
(775) 727-0900
(702) 727-0902
Mailing address
1875 S NELLIS BLVD, LAS VEGAS, NV 89104-6215
(702) 254-6821
(702) 243-5012
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
6711
AZ
363AM0700X
Medical Physician Assistant
Primary
PA0347
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477655223
—
NV
01
—
70003254
RAILROAD MEDICARE
NV
01
—
PA0347
NV STATE MEDICAL LICENSE
NV
Enumeration date
09/02/2006
Last updated
03/17/2018
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