Provider Demographics
NPI:1699794529
Name:PEPRAH, ROBERT M (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:PEPRAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6039 ELDORA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5611
Mailing Address - Country:US
Mailing Address - Phone:702-228-4900
Mailing Address - Fax:702-228-1177
Practice Address - Street 1:6039 ELDORA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5611
Practice Address - Country:US
Practice Address - Phone:702-228-4900
Practice Address - Fax:702-228-1177
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV68212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019499Medicaid
NV002019499Medicaid
NV38491Medicare PIN