Provider Demographics
NPI:1144392903
Name:VYAS, CHIRAG (MD)
Entity Type:Individual
Prefix:
First Name:CHIRAG
Middle Name:
Last Name:VYAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15645
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89114-5645
Mailing Address - Country:US
Mailing Address - Phone:702-617-1227
Mailing Address - Fax:702-616-2069
Practice Address - Street 1:2825 SIENA HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3976
Practice Address - Country:US
Practice Address - Phone:702-617-1227
Practice Address - Fax:702-616-2069
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236974207V00000X
NVN4826207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1144392903Medicaid
NYRA7668Medicare PIN
NVCC284ZMedicare PIN