MEDICARE: RANADEV MUKHERJEE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	9886	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861593790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANADEV MUKHERJEE MD

Provider Business Mailing Address
First Line	:	840 S RANCHO DR
Second Line	:	SUITE 4 #342
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3837
Country	:	US
Telephone Number	:	702-202-3431
Fax Number	:	702-202-3455

Provider Business Practice Location Address
First Line	:	2031 MCDANIEL ST
Second Line	:	SUITE #210
City	:	N LAS VEGAS
State	:	NV
Zip	:	89030-6303
Country	:	US
Telephone Number	:	702-633-0207
Fax Number	:	702-633-5099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	11/23/2011

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Directions to “ RANADEV MUKHERJEE MD” Practice Location

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