Ingham, Maxine Bonnie
Ingham, Maxine Bonnie is an sole proprietor health care provider with primary practice located at 2940 S Jones Blvd Suite E, Las Vegas NV 89146-5636. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Ingham, Maxine Bonnie can be contacted via phone (702) 227-6947.Contact Information
Primary practice address
2940 S Jones Blvd Suite E
Las Vegas NV 89146-5636
Phone: (702) 227-6947
Fax: (702) 247-4319
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | 8528 | Nevada |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | C42144 | California |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | M-10233 | Idaho |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | C42144 | California |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 8528 | Nevada |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 8528 | Nevada |
Profile Details
| NPI number | 1730294455 |
|---|---|
| LBN Legal business name | Ingham, Maxine Bonnie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 21st, 2006 |
| Last updated | Oct 25th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730294455 | NPPES |
| Nevada | MEDICAID | 002016755 |
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