Individual
MR. BRENT DAMON MICHAELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4488 S PECOS RD, LAS VEGAS, NV 89121-5030
(702) 436-1001
(702) 436-3858
Mailing address
9097 W POST RD, STE 100, LAS VEGAS, NV 89148-2417
(702) 430-5333
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
SL0590
NV
207N00000X
Dermatology Physician
Primary
DO1715
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01115811
RR MEDICARE
NV
Enumeration date
08/13/2008
Last updated
03/26/2018
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