MEDICARE: SHANKER N DIXIT 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
1	2084N0400X	Neurology Physician	38555	WI
2	2084N0600X	Clinical Neurophysiology Physician	9739	NV
3	2084N0400X	Neurology Physician	9739	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477558674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANKER N DIXIT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 33340
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-3340
Country	:	US
Telephone Number	:	702-405-3015
Fax Number	:	702-405-3017

Provider Business Practice Location Address
First Line	:	2440 PROFESSIONAL CT
Second Line	:	SUITE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0838
Country	:	US
Telephone Number	:	702-405-3015
Fax Number	:	702-405-3017

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	08/04/2021

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Directions to “ SHANKER N DIXIT M.D.” Practice Location

Language	Start Address	Practice Location

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