Provider Demographics
NPI:1962205013
Name:MLM MEDICAL SERVICES
Entity type:Organization
Organization Name:MLM MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:CONRAD
Authorized Official - Last Name:MCCOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-860-5388
Mailing Address - Street 1:267 OAKBROOK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-3394
Mailing Address - Country:US
Mailing Address - Phone:702-860-5388
Mailing Address - Fax:
Practice Address - Street 1:55 S VALLE VERDE DR STE 265
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3434
Practice Address - Country:US
Practice Address - Phone:702-860-5388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty