Provider Demographics
NPI:1124086491
Name:BROBBEY, AMA B (MD)
Entity type:Individual
Prefix:DR
First Name:AMA
Middle Name:B
Last Name:BROBBEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 98978
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8978
Mailing Address - Country:US
Mailing Address - Phone:702-507-2466
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:1000 S RAINBOW BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-6231
Practice Address - Country:US
Practice Address - Phone:702-464-8866
Practice Address - Fax:702-671-6851
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV10647207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1124086491Medicaid
NV1124086491Medicaid
NVEK149Y (CQ328A)Medicare PIN
NVEK149ZMedicare PIN
NVEK149X (CQ328B)Medicare PIN