Provider Demographics
NPI:1053384578
Name:MARCHIO, WILLIAM ALAN
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALAN
Last Name:MARCHIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15645
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89114-5645
Mailing Address - Country:US
Mailing Address - Phone:702-242-7308
Mailing Address - Fax:702-240-8790
Practice Address - Street 1:2450 W CHARLESTON
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-877-8660
Practice Address - Fax:702-258-1322
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9530207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2018371Medicaid
NV2018371Medicaid
NV33790Medicare PIN