Individual
EBERHARD JOHANNES MAENDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
630 S RANCHO DR, SUITE E, LAS VEGAS, NV 89106-4873
(702) 258-1001
(702) 258-3455
Mailing address
2285 CORPORATE CIR, STE 200, HENDERSON, NV 89074-7759
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
569
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00436130
RAILROAD MEDICARE PTAN
NV
01
—
P00852334
RR MEDICARE NV 10/2010
NV
Enumeration date
08/12/2005
Last updated
03/15/2016
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