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General NPI Number Information
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NPI Number | 1881888956
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Entity Type | Organization
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Legal Business Name | RADAR MEDICAL GROUP LLP
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 2628 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-2176
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Country | US
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Telephone | 702-644-0500
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Fax | 702-641-4600
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Provider Business Mailing Address
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Address Line | 10624 S EASTERN AVE STE A-425
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City | HENDERSON
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State | NV
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Zip | 89052-2982
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Country | US
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Telephone | 702-644-0500
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Fax | 702-641-4600
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/DOCTOR
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Name | MRS. DIPTI R. SHAH
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Credential | M.D.
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Telephone | 702-644-0500
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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 |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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