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General NPI Number Information
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NPI Number | 1003854597
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Entity Type | Individual
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Provider Name | RAHUL NAVIN MEDIWALA
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Gender | Male
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 1500 E 2ND ST SUITE 201
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City | RENO
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State | NV
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Zip | 89502-1262
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Country | US
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Telephone | 775-982-3355
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Fax | 775-982-3356
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Provider Business Mailing Address
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Address Line | 780 KUENZLI ST SUITE 202
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City | RENO
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State | NV
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Zip | 89502-0845
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Country | US
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Telephone | 775-982-4590
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Fax | 775-982-4595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 35082124
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | TP512
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 12845
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License Number State | NV
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