Provider Demographics
NPI:1063436517
Name:RAND, ROBERT GENE (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:GENE
Last Name:RAND
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 1:6880 S MCCARRAN BLVD
Mailing Address - Street 2:STE14
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6175
Mailing Address - Country:US
Mailing Address - Phone:775-826-7263
Mailing Address - Fax:
Practice Address - Street 1:6880 S MCCARRAN BLVD
Practice Address - Street 2:STE14
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6175
Practice Address - Country:US
Practice Address - Phone:775-826-7263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00294279OtherRR
NV100506730Medicaid
P00294279OtherRR
101705Medicare PIN