Basic Information
Provider Information
NPI: 1811428758
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAUBS
FirstName: GREGORY
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1800 W. CHARLESTON BLVD.
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 89102
CountryCode: US
TelephoneNumber: 7023832273
FaxNumber: 7023832091
Practice Location
Address1: 1800 W. CHARLESTON BLVD.
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 89102
CountryCode: US
TelephoneNumber: 7023832273
FaxNumber: 7023832091
Other Information
ProviderEnumerationDate: 03/22/2017
LastUpdateDate: 09/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207X00000X22252NVY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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