Provider Demographics
NPI:1407988389
Name:TSUDA, SHAWN T (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:T
Last Name:TSUDA
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 34270
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4270
Mailing Address - Country:US
Mailing Address - Phone:702-500-1646
Mailing Address - Fax:702-487-6006
Practice Address - Street 1:653 N TOWN CENTER DR STE 510
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0519
Practice Address - Country:US
Practice Address - Phone:702-448-5578
Practice Address - Fax:702-703-2375
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12532208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery