| Mahendra Defonseka, Md, Chtd | |
|
98 E Lake Mead Pkwy Suite 302 Henderson NV 89015-5540 | |
| (702) 565-3037 | |
| Not Available |
| Full Name | Mahendra Defonseka, Md, Chtd |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 98 E Lake Mead Pkwy, Henderson, Nevada |
| Authorized Official Name and Position | Mahendra Defonseka (OWNER) |
| Authorized Official Contact | 7025653037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahendra Defonseka, Md, Chtd 3022 S Durango Dr Suite 100 Las Vegas NV 89117-4439 Ph: (702) 967-2352 | Mahendra Defonseka, Md, Chtd 98 E Lake Mead Pkwy Suite 302 Henderson NV 89015-5540 Ph: (702) 565-3037 |
| NPI Number | 1700838042 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 03/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700838042 | NPI | - | NPPES |
| 002002520 | Medicaid | NV | |
| NV3383 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | NV3983 (Nevada) | Primary |
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