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Individual

ANSLEM A OPARAUGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3050 E BONANZA RD, SUITE 130, LAS VEGAS, NV 89101-3703
(702) 383-0663
(702) 383-0163
Mailing address
3050 E BONANZA RD, SUITE 130, LAS VEGAS, NV 89101-3703
(702) 383-0663
(702) 383-0163

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10268
NV
2080P0208X
Pediatric Infectious Diseases Physician
10268
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002018811
NV
05
1386962322
NV
Enumeration date
08/08/2006
Last updated
08/01/2012
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