Individual
STEPHEN BERNARD ANDRACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1397 S LOOP RD, PAHRUMP, NV 89048-4729
(775) 727-5500
(775) 727-5696
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5764
NV
208D00000X
General Practice Physician
5764
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598708901
—
NV
01
—
5764
STATE LICENSE
NV
Enumeration date
06/14/2006
Last updated
10/14/2022
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