Provider Demographics
NPI:1962541615
Name:ANGUS, ARSENIO S (MD)
Entity type:Individual
Prefix:DR
First Name:ARSENIO
Middle Name:S
Last Name:ANGUS
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 1:2031 MCDANIEL ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6303
Mailing Address - Country:US
Mailing Address - Phone:702-642-9029
Mailing Address - Fax:702-642-5280
Practice Address - Street 1:2031 MCDANIEL ST
Practice Address - Street 2:SUITE 140
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6303
Practice Address - Country:US
Practice Address - Phone:702-642-9029
Practice Address - Fax:702-642-5280
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3806173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC95730Medicare UPIN
NVBFBVKMedicare ID - Type Unspecified