Phoenix, Wynter Nigel

Phoenix, Wynter Nigel is an individual health care provider with primary practice located at 1211 Pleasant Grove Blvd Ste 120, Roseville CA 95678. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Phoenix, Wynter Nigel can be contacted via phone (916) 791-8346.

Contact Information

Primary practice address
1211 Pleasant Grove Blvd Ste 120 Roseville CA 95678
Fax: (916) 791-8833
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 12345 Nevada

Profile Details

NPI number 1548432974
LBN Legal business name Phoenix, Wynter Nigel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2008
Last updated Sep 6th, 2023 - about 2 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 1548432974 NPPES
Other 1548432974 NPI
MEDICAID 1548432974 NPI

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