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General NPI Number Information
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NPI Number | 1639257264
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Entity Type | Individual
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Provider Name | ROSHAN RAJA DO
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 2821 W HORIZON RIDGE PKWY STE. 100
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City | HENDERSON
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State | NV
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Zip | 89052-4427
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Country | US
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Telephone | 702-920-0290
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Fax | 702-789-1050
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Provider Business Mailing Address
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Address Line | 2821 W HORIZON RIDGE PKWY STE. 100
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City | HENDERSON
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State | NV
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Zip | 89052-4427
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Country | US
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Telephone | 702-920-0290
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Fax | 702-789-1050
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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 | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | DO1405
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License Number State | NV
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