| Suditi | |
|
3100 N Tenaya Way Las Vegas NV 89128-0436 | |
| (702) 401-4202 | |
| Not Available |
| Full Name | Suditi |
|---|---|
| Speciality | Internal Medicine |
| Location | 3100 N Tenaya Way, Las Vegas, Nevada |
| Authorized Official Name and Position | Sujay L Patel (PHYSICIAN) |
| Authorized Official Contact | 7024014202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suditi 2505 Anthem Village Dr Suite E-134 Henderson NV 89052-5505 Ph: (702) 401-4202 | Suditi 3100 N Tenaya Way Las Vegas NV 89128-0436 Ph: (702) 401-4202 |
| NPI Number | 1962640946 |
|---|---|
| Provider Enumeration Date | 01/28/2009 |
| Last Update Date | 01/28/2009 |
| Medicare PECOS PAC ID | 5092872283 |
|---|---|
| Medicare Enrollment ID | O20090313000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962640946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | DO01457 (Nevada) | Primary |
| Provider Name | Sujay Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134243454 PECOS PAC ID: 1759448939 Enrollment ID: I20090316000658 |
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