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Individual

ALAN DETIBERIIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.PATH, DNP

Contact information

Practice address
1205 W WARM SPRINGS RD STE 100, HENDERSON, NV 89014-8741
(702) 265-3033
Mailing address
1208 SEMINOLE LN, HENDERSON, NV 89015-5565
(702) 265-3033

Taxonomy

Speciality
Code
Description
License number
State
207ZC0008X
Clinical Informatics (Pathology) Physician
Primary
405787
NV
207ZP0101X
Anatomic Pathology Physician
D-16-1125-1121-A
ZZ
374K00000X
Religious Nonmedical Practitioner
NA
NV

Other

Enumeration date
07/28/2017
Last updated
01/20/2022
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