Individual provider · Type 1 NPI
Steven Legrand Mayberry, DO
Military Health Care Provider · North Nellis Afb, NV
NPI number
1790436632
Active
Practice location
99th Medical Group, 4700 Las Vegas Blvd
North Nellis Afb, NV 89191-6601
Mailing address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Military Health Care Provider Primary | 171000000X | 5101028896 (MI) |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
About NPI 1790436632
Steven Legrand Mayberry, DO's National Provider Identifier is 1790436632, issued on Jan 12, 2022. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in North Nellis Afb, NV. The record was last updated on Aug 24, 2026.