Provider Demographics
NPI:1144618349
Name:BHARWANI, DINESH
Entity Type:Individual
Prefix:
First Name:DINESH
Middle Name:
Last Name:BHARWANI
Suffix:
Gender:M
Credentials:
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:SOUTHWEST MEDICAL ASSOCIATES
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89114-5645
Mailing Address - Country:US
Mailing Address - Phone:702-579-3298
Mailing Address - Fax:702-667-4689
Practice Address - Street 1:270 WEST LAKE MEAD PARKWAY
Practice Address - Street 2:SOUTHWEST MEDICAL ASSOCIATES
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015
Practice Address - Country:US
Practice Address - Phone:702-677-3720
Practice Address - Fax:702-677-3733
Is Sole Proprietor?:No
Enumeration Date:2014-12-23
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1144618349Medicaid
NVV109792Medicare PIN