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General NPI Number Information
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NPI Number | 1689762239
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Entity Type | Organization
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Legal Business Name | RAJEEV PRASAD MD PC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 N GREEN VALLEY PKWY SUITE 110
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City | HENDERSON
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State | NV
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Zip | 89074-6391
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Country | US
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Telephone | 702-436-7700
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Fax | 702-898-5428
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Provider Business Mailing Address
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Address Line | 100 N GREEN VALLEY PKWY SUITE 110
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City | HENDERSON
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State | NV
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Zip | 89074-6391
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Country | US
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Telephone | 702-436-7700
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Fax | 702-898-5428
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAJEEV PRASAD
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Credential | M.D.
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Telephone | 702-436-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 11805
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License Number State | NV
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