Individual
MENTE DALERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
653 N TOWN CENTER DR STE 10, LAS VEGAS, NV 89144-0503
(702) 733-0981
Mailing address
4513 SEA DREAM AVE, N LAS VEGAS, NV 89031-3483
(702) 586-0830
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
13135
NV
2080N0001X
Neonatal-Perinatal Medicine Physician
4301045255
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2341592
ECFMG
—
01
—
4301045255
CONTROLLED SUBSTANCE
—
05
—
4589791
—
MI
Enumeration date
10/07/2005
Last updated
03/07/2023
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