Individual
WYNTER NIGEL PHOENIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1211 PLEASANT GROVE BLVD, STE 120, ROSEVILLE, CA 95678
(916) 791-8346
(916) 791-8833
Mailing address
1211 PLEASANT GROVE BLVD, STE 120, ROSEVILLE, CA 95678
(916) 791-8346
(916) 791-8833
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12345
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548432974
NPI
—
05
—
1548432974
—
NV
Enumeration date
03/26/2008
Last updated
09/06/2023
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