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General NPI Number Information
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NPI Number | 1578012670
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Entity Type | Organization
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Legal Business Name | OGANES SHILGEVORKYAN MD PLLC
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Dates
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Enumeration Date | 09/29/2016
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 3022 S DURANGO DR STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89117-4440
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Country | US
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Telephone | 702-256-3637
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Fax | 877-991-2948
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Provider Business Mailing Address
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Address Line | 500 N RAINBOW BLVD SUITE 300
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City | LAS VEGAS
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State | NV
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Zip | 89107-1082
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OGANES HOVIK SHILGEVORKYAN
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Credential | M.D.
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Telephone | 818-621-8142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 16480
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License Number State | NV
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