Provider Demographics
NPI:1316909864
Name:KANTOR, SAMUEL ADAM (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:ADAM
Last Name:KANTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2545 S BRUCE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-1778
Mailing Address - Country:US
Mailing Address - Phone:702-732-2438
Mailing Address - Fax:702-737-5043
Practice Address - Street 1:1581 MOUNT MARIAH DR STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-1506
Practice Address - Country:US
Practice Address - Phone:702-851-7766
Practice Address - Fax:702-851-7760
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2024-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV12391207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1316909864Medicaid
AZ300692Medicaid
AZ300692Medicaid
GA884321689AMedicaid
AZ300692Medicaid
NVHM190ZMedicare PIN
NV1316909864Medicaid