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2610 W Horizon Ridge Pkwy Ste 100 Henderson NV 89052-2870 | |
(702) 578-5737 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 2610 W Horizon Ridge Pkwy Ste 100, Henderson, Nevada |
Authorized Official Name and Position | Dhaval Shah (OWNER/MEDICAL DIRECTOR) |
Authorized Official Contact | 7025785737 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 36830 Las Vegas NV 89133-6830 Ph: () - | 2610 W Horizon Ridge Pkwy Ste 100 Henderson NV 89052-2870 Ph: (702) 578-5737 |
NPI Number | 1396485330 |
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Provider Enumeration Date | 03/29/2022 |
Last Update Date | 04/07/2022 |
Medicare PECOS PAC ID | 8729475124 |
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Medicare Enrollment ID | O20220504001613 |
Identifier | Type | State | Issuer |
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1396485330 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
Provider Name | Dhaval J Shah |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1194711358 PECOS PAC ID: 1658465141 Enrollment ID: I20070914000057 |
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