Organization
NATHAN IBE OZOBIA MD CHARTERED
Active
Parent organization
NATHAN IBE OZOBIA MD FICS CHARTERED
Organization subpart
Yes
Provider details
NPI number
Legal business name
NATHAN IBE OZOBIA MD FICS CHARTERED
Authorized official
DR. NATHAN IBEZIMAKO OZOBIA MD FACS (PRESIDENT)
(702) 643-0500
Entity
Organization
Contact information
Practice address
5701 W CHARLESTON BLVD, SUITE 105, LAS VEGAS, NV 89146-1217
(702) 643-0500
(702) 471-1049
Mailing address
PO BOX 27619, LAS VEGAS, NV 89126-1619
(702) 643-0500
(702) 471-1049
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3239
NV
282N00000X
General Acute Care Hospital
3239
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS969A
MEDICARE PTAN
NV
Enumeration date
02/10/2010
Last updated
09/25/2014
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