Individual
ETHAN MILTON CRUVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8205 W. WARM SPRINGS RD., SUITE 110, LAS VEGAS, NV 89113
(702) 735-8734
(702) 735-2726
Mailing address
8205 W. WARM SPRINGS RD., SUITE 110, LAS VEGAS, NV 89113-3612
(702) 735-8734
(702) 735-2726
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5854
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002019008
—
NV
01
—
110227382
RAILROAD MEDICARE
—
01
—
880344806A002
TRIWEST
—
Enumeration date
06/30/2005
Last updated
06/14/2011
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