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NPI Code Detail

MEDICARE: DR. BALJIT SINGH DEOL M.D.

MEDICARE: DR. BALJIT SINGH DEOL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085N0700XNeuroradiology Physician4301065786MI
22085R0202XDiagnostic Radiology Physician4301065786MI
32085R0202XDiagnostic Radiology Physician25615NV
42085R0204XVascular & Interventional Radiology Physician4301065786MI
52085R0204XVascular & Interventional Radiology Physician25615NV
62085N0700XNeuroradiology Physician25615NV

General Provider Information

NPI Number : 1417908278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BALJIT SINGH DEOL M.D.
Provider Business Mailing Address
First Line : 1800 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2386
Country : US
Telephone Number : 702-383-2000
Fax Number :
Provider Business Practice Location Address
First Line : 1800 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2386
Country : US
Telephone Number : 702-383-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 03/11/2025

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