Provider Demographics
NPI:1548636285
Name:ALMA MAY F DEWEY MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ALMA MAY F DEWEY MD A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLER/BOOKKEEPER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:DEWEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-376-0783
Mailing Address - Street 1:9484 S EASTERN AVE
Mailing Address - Street 2:#102
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-3987
Mailing Address - Country:US
Mailing Address - Phone:702-492-9990
Mailing Address - Fax:702-616-7032
Practice Address - Street 1:9484 S EASTERN AVE
Practice Address - Street 2:#102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-3987
Practice Address - Country:US
Practice Address - Phone:702-492-9990
Practice Address - Fax:702-616-7032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8669261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1447397625OtherINDIVIDUAL NPI
V34253Medicare PIN