Individual
SHELDON M KOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2874 N CARSON ST STE 215, CARSON CITY, NV 89706-1682
(775) 445-5500
(775) 852-6902
Mailing address
PO BOX 2087, CARSON CITY, NV 89702-2087
(775) 882-0430
(775) 852-6902
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5590
NV
2085R0202X
Diagnostic Radiology Physician
G54188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002013003
—
NV
01
—
300034706
RAILROAD MEDICARE
NV
01
—
30WCCBR04
MEDICARE PTAN
NV
01
—
AX909X
MEDICARE PTAN
CA
01
—
FS4913489
MEDICAL
CA
Enumeration date
07/06/2006
Last updated
09/18/2014
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