| Elite Medical Group Llc | |
|
2170 E Harmon Ave Las Vegas NV 89119-7840 | |
| (702) 509-9904 | |
| (702) 509-9921 |
| Full Name | Elite Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2170 E Harmon Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Manoj Nath (MD) |
| Authorized Official Contact | 7025099904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Medical Group Llc 8687 W Sahara Ave Ste 200 Las Vegas NV 89117-5869 Ph: (702) 509-9904 | Elite Medical Group Llc 2170 E Harmon Ave Las Vegas NV 89119-7840 Ph: (702) 509-9904 |
| NPI Number | 1841841541 |
|---|---|
| Provider Enumeration Date | 09/24/2019 |
| Last Update Date | 11/15/2022 |
| Medicare PECOS PAC ID | 5294067757 |
|---|---|
| Medicare Enrollment ID | O20191101001562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841841541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Nadeem Tariq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750330726 PECOS PAC ID: 2466351218 Enrollment ID: I20031231000375 |
| Provider Name | Gnaneswer Billakanti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922180595 PECOS PAC ID: 3577532803 Enrollment ID: I20041001000986 |
| Provider Name | Manoj Nath |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881799146 PECOS PAC ID: 0042101156 Enrollment ID: I20070301000692 |
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