Organization
CHILDRENS NEPHROLOGY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL O AIGBE M.D. (OWNER)
(702) 639-1700
Entity
Organization
Contact information
Practice address
3201 S MARYLAND PKWY, SUITE 606, LAS VEGAS, NV 89109-2441
(702) 639-1700
(702) 639-1717
Mailing address
3201 S MARYLAND PKWY, SUITE 606, LAS VEGAS, NV 89109-2441
(702) 639-1700
(702) 639-1717
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9506
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H22090
UPIN
NH
Enumeration date
03/04/2008
Last updated
03/04/2008
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