Provider Demographics
NPI:1174547798
Name:SPIRTOS, NICOLA M (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLA
Middle Name:M
Last Name:SPIRTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SHADOW LN STE 370
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4159
Mailing Address - Country:US
Mailing Address - Phone:702-693-6870
Mailing Address - Fax:702-693-6899
Practice Address - Street 1:700 SHADOW LN STE 370
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4159
Practice Address - Country:US
Practice Address - Phone:702-693-6870
Practice Address - Fax:702-693-6899
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8131207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016615Medicaid
NV002016615Medicaid
V31370Medicare ID - Type Unspecified