Provider Demographics
NPI:1104895119
Name:MARS, GEORGE (MD)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:MARS
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 1:645 SIERRA ROSE #202
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511
Mailing Address - Country:US
Mailing Address - Phone:775-825-9990
Mailing Address - Fax:775-827-1161
Practice Address - Street 1:645 SIERRA ROSE #202
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511
Practice Address - Country:US
Practice Address - Phone:775-825-9990
Practice Address - Fax:775-827-1161
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8649208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG83065Medicare UPIN