Individual
MR. MICHAEL SCOTT MALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7455 W WASHINGTON AVE, #400, LAS VEGAS, NV 89128-4337
(702) 733-7966
(702) 341-0504
Mailing address
7455 W WASHINGTON AVE, #400, LAS VEGAS, NV 89128-4337
(702) 733-7966
(702) 341-0504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NV6074
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002019017
—
NV
05
—
003102017
—
NV
Enumeration date
08/09/2006
Last updated
08/12/2025
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