Basic Information
| Provider Information | |||||||||
| NPI: | 1205848132 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIORE | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 W 2ND ST | ||||||||
| Address2: | 235D | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895035345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757841223 | ||||||||
| FaxNumber: | 7753272006 | ||||||||
| Practice Location | |||||||||
| Address1: | UNSOM 123 17TH STREET BRIGHAM BLDG MS 316 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895570001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757841533 | ||||||||
| FaxNumber: | 7757848075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 02/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 6575 | NV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 002016448 | 05 | NV | MEDICAID |