Individual
DR. DAVID RAY WICHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5785 CENTENNIAL CENTER BLVD STE 230, LAS VEGAS, NV 89149
(702) 383-2273
(702) 366-0570
Mailing address
1800 W CHARLESTON BLVD STE 508, LAS VEGAS, NV 89102
(702) 383-2688
(702) 671-6595
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
551
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019609
—
NV
01
—
32922
BLUE CROSS
NV
Enumeration date
04/07/2006
Last updated
10/04/2018
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