| Shilpa B Thaker Md Ltd | |
|
3150 N Tenaya Way Suite 225 Las Vegas NV 89128-0443 | |
| (702) 558-2111 | |
| (702) 558-8333 |
| Full Name | Shilpa B Thaker Md Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 3150 N Tenaya Way, Las Vegas, Nevada |
| Authorized Official Name and Position | Lori Ann Labrecque (ACCOUNTS MGR) |
| Authorized Official Contact | 7024533799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shilpa B Thaker Md Ltd 3324 Canoe Cove Ct Las Vegas NV 89117-6713 Ph: (702) 303-2076 | Shilpa B Thaker Md Ltd 3150 N Tenaya Way Suite 225 Las Vegas NV 89128-0443 Ph: (702) 558-2111 |
| NPI Number | 1891010799 |
|---|---|
| Provider Enumeration Date | 04/02/2010 |
| Last Update Date | 11/03/2011 |
| Medicare PECOS PAC ID | 5294850079 |
|---|---|
| Medicare Enrollment ID | O20100916000896 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891010799 | NPI | - | NPPES |
| 13297 | Other | NV | NEVADA LIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 13297 (Nevada) | Primary |
| Provider Name | Shilpa B Thaker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609991959 PECOS PAC ID: 7719002500 Enrollment ID: I20100916001105 |
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