| Internal Medicine Clinic Banerji Ltd | |
|
5731 S Fort Apache Rd Ste 100 Las Vegas NV 89148-5620 | |
| (702) 740-5311 | |
| (702) 740-5310 |
| Full Name | Internal Medicine Clinic Banerji Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 5731 S Fort Apache Rd Ste 100, Las Vegas, Nevada |
| Authorized Official Name and Position | Bashab Banerji (OWNER) |
| Authorized Official Contact | 7027405311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Clinic Banerji Ltd 5731 South Fort Apache Road Suite A Las Vegas NV 89148 Ph: (702) 740-5311 | Internal Medicine Clinic Banerji Ltd 5731 S Fort Apache Rd Ste 100 Las Vegas NV 89148-5620 Ph: (702) 740-5311 |
| NPI Number | 1851403646 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 07/03/2019 |
| Medicare PECOS PAC ID | 3476546318 |
|---|---|
| Medicare Enrollment ID | O20040406000992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851403646 | NPI | - | NPPES |
| DD5081 | Other | NV | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 9544 (Nevada) | Primary |
| Provider Name | Bashab Banerji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659379717 PECOS PAC ID: 4082607932 Enrollment ID: I20040414000912 |
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