Provider Demographics
NPI:1962931584
Name:GIDAYA, ALEXANDER B (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:B
Last Name:GIDAYA
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 1:8930 W SUNSET RD # 250
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5008
Mailing Address - Country:US
Mailing Address - Phone:702-565-8346
Mailing Address - Fax:702-202-2000
Practice Address - Street 1:8930 W SUNSET RD # 250
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5008
Practice Address - Country:US
Practice Address - Phone:702-565-8346
Practice Address - Fax:702-202-2000
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV25860208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery