Basic Information
| Provider Information | |||||||||
| NPI: | 1528210978 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REAM | ||||||||
| FirstName: | ADRIAN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RPA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 S RANCHO DR | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891063854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024770772 | ||||||||
| FaxNumber: | 7024770486 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 S RANCHO DR | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891063854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024770772 | ||||||||
| FaxNumber: | 7024770486 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2008 | ||||||||
| LastUpdateDate: | 10/16/2008 | ||||||||
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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 | 243U00000X | 08 NV 1009 | NV | Y | Technologists, Technicians & Other Technical Service Providers | Radiology Practitioner Assistant |
No ID Information.