Fouse, Mervyn Bruce

Fouse, Mervyn Bruce is an individual health care provider with primary practice located at 2800 E Desert Inn Rd Suite 100, Las Vegas NV 89121-3608. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Fouse, Mervyn Bruce can be contacted via phone (702) 731-1616.

Contact Information

Primary practice address
2800 E Desert Inn Rd Suite 100 Las Vegas NV 89121-3608
Fax: (702) 731-0741
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 5401 Nevada

Profile Details

NPI number 1598743916
LBN Legal business name Fouse, Mervyn Bruce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Mar 15th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598743916 NPPES
Nevada MEDICAID 2002961
Nevada Other NV8839
Nevada Other 200006951
Nevada Other 4294880

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