Potruch, Theodore
Potruch, Theodore is an individual health care provider with primary practice located at 2123 Civic Center Dr , North Las Vegas NV 89030-6327. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Potruch, Theodore can be contacted via phone (702) 333-1110.Contact Information
Primary practice address
2123 Civic Center Dr
North Las Vegas NV 89030-6327
Phone: (702) 333-1110
Fax: (702) 685-0744
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 3310 | Nevada |
Profile Details
| NPI number | 1649225293 |
|---|---|
| LBN Legal business name | Potruch, Theodore |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Mar 6th, 2018 - about 6 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 | 1649225293 | NPPES |
| Nevada | Other | V50306 | MEDICARE PTAN |
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