Individual
NICHOLAS TIBALDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2316 W CHARLESTON BLVD, SUITE 280, LAS VEGAS, NV 89102-2149
(702) 877-8330
(702) 877-8312
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 877-8330
(702) 877-8312
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
11661
NV
207RG0100X
Gastroenterology Physician
19721
WV
207RG0100X
Gastroenterology Physician
35065820
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151302
—
OH
05
—
1760478564
—
NV
05
—
6000016000
—
WV
Enumeration date
09/27/2005
Last updated
02/14/2014
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