Individual
DR. LOWELL THOMAS NIEBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2800 E DESERT INN RD, SUITE 100, LAS VEGAS, NV 89121-3608
(702) 731-1616
(702) 731-0741
Mailing address
2800 E DESERT INN RD, #100, LAS VEGAS, NV 89121-3608
(702) 731-1616
(702) 731-0741
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2576
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200002160
R.R. MEDICARE
—
05
—
2002357
—
NV
01
—
4297372
AETNA
—
01
—
NV2576
BXBS
—
Enumeration date
01/05/2006
Last updated
10/21/2011
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