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NPI Code Detail

MEDICARE: SADAF KEROLES PA-C

MEDICARE: SADAF KEROLES PA-C
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
1363AM0700XMedical Physician AssistantPA1174NV

General Provider Information

NPI Number : 1518195247
Entity Type Code : Individual
Provider Name (Legal Business Name) : SADAF KEROLES PA-C
Provider Business Mailing Address
First Line : 9030 W SAHARA AVE
Second Line : #249
City : LAS VEGAS
State : NV
Zip : 89117-5744
Country : US
Telephone Number : 702-921-6829
Fax Number : 702-974-1606
Provider Business Practice Location Address
First Line : 7251 W LAKE MEAD BLVD STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-8380
Country : US
Telephone Number : 702-629-6992
Fax Number : 702-974-1606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2009
Last Update Date : 10/21/2021

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Directions to “ SADAF KEROLES PA-C” Practice Location

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