Provider Demographics
NPI:1164613188
Name:PANWAR, SADIK RAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:SADIK
Middle Name:RAJA
Last Name:PANWAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 370327
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0327
Mailing Address - Country:US
Mailing Address - Phone:702-477-7044
Mailing Address - Fax:702-388-1664
Practice Address - Street 1:7010 SMOKE RANCH RD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8399
Practice Address - Country:US
Practice Address - Phone:702-477-7044
Practice Address - Fax:702-388-1664
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV18961207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV250002873Medicaid