MEDICARE: DIGESTIVE ASSOCIATES LLP

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	207RG0100X	Gastroenterology Physician	9886	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1007232420	OTHER	NV	NV STATE BUSINESS LICENSE

General Provider Information

NPI Number	:	1629242698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGESTIVE ASSOCIATES LLP

Provider Business Mailing Address
First Line	:	2031 MCDANIEL ST STE 140
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6308
Country	:	US
Telephone Number	:	702-633-0207
Fax Number	:	702-633-5099

Provider Business Practice Location Address
First Line	:	2031 MCDANIEL ST STE 140
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6308
Country	:	US
Telephone Number	:	702-633-0207
Fax Number	:	702-633-5099

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	RANADEV MUKHERJEE
Credential	:	MD
Telephone Number	:	702-204-0435

Provider Enumeration Date	:	04/21/2008
Last Update Date	:	01/24/2025

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Directions to “DIGESTIVE ASSOCIATES LLP ” Practice Location

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