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General NPI Number Information
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NPI Number | 1417335845
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Entity Type | Individual
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Provider Name | RITESH KORUMILLI M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 3186 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89109-2317
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Country | US
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Telephone | 702-961-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 340 SE 3RD ST APT 3411
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City | MIAMI
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State | FL
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Zip | 33131-1754
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Country | US
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Telephone | 914-356-1847
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 20960
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License Number State | NV
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