Basic Information
Provider Information
NPI: 1538148432
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LITT
FirstName: ROBERT
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4101 WAGON TRAIL AVE
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891184426
CountryCode: US
TelephoneNumber: 7029424123
FaxNumber: 7029424124
Practice Location
Address1: 3061 S MARYLAND PKWY
Address2: SUITE 102
City: LAS VEGAS
State: NV
PostalCode: 891092298
CountryCode: US
TelephoneNumber: 7027312888
FaxNumber: 7026969289
Other Information
ProviderEnumerationDate: 01/10/2006
LastUpdateDate: 02/18/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X4046NVY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
NV404601NVBLUEOTHER
20029020405NV MEDICAID


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