Individual
DOMINIC L. RICCIARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5572 S FORT APACHE RD STE 110, LAS VEGAS, NV 89148-3605
(702) 492-8281
Mailing address
5572 S FORT APACHE RD STE 110, LAS VEGAS, NV 89148-3605
(702) 503-5592
(702) 974-1268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11899
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100511080
—
NV
Enumeration date
08/30/2006
Last updated
10/14/2024
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