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Individual

MICHAEL EISENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5495 S RAINBOW BLVD STE 101, LAS VEGAS, NV 89118-1872
(702) 477-0772
Mailing address
PO BOX 30077, DEPT 305, SALT LAKE CITY, UT 84130-0077
(877) 243-8416

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
6307
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
152974
WC
NV
01
153100
WC
NV
05
200290109
NV
01
NV4208
BCBS
NV
01
NV4870
BCBS
NV
Enumeration date
05/16/2006
Last updated
10/20/2017
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