Healthcare Provider Details

I. General information

NPI: 1811975642
Provider Name (Legal Business Name): NEEL VALLABHDAS DHUDSHIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10001 S EASTERN AVE STE 201
HENDERSON NV
89052-3908
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 702-616-5700
  • Fax: 702-982-6347
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number11049
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: