Individual
ROBERT MODUGNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9260 W SUNSET RD, SUITE 200, LAS VEGAS, NV 89148-4858
(702) 255-3547
(702) 921-2419
Mailing address
9260 W SUNSET RD, SUITE 200, LAS VEGAS, NV 89148-4858
(702) 255-3547
(702) 921-2419
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
029496
GA
207VX0000X
Obstetrics Physician
029496
GA
207VX0000X
Obstetrics Physician
Primary
16437
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000453274H
—
GA
05
—
000453274S
—
GA
01
—
0762454
CIGNA
NC
01
—
1439X
BLUE CROSS BLUE SHIELD
NC
01
—
202I164773
MEDICARE
GA
01
—
3047867
UNITED HEALTHCARE
GA
01
—
4134092
UNITED HEALTHCARE
GA
05
—
5905360
—
NC
01
—
6581
COVENTRY
GA
01
—
P00605634
RAILROAD MEDICARE
NC
Enumeration date
07/27/2006
Last updated
02/01/2017
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