Provider Demographics
NPI:1558427526
Name:INFECTIOUS DISEASE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DHIRESH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-279-8614
Mailing Address - Street 1:PO BOX 400548
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-0548
Mailing Address - Country:US
Mailing Address - Phone:702-279-8614
Mailing Address - Fax:702-202-1015
Practice Address - Street 1:6867 W CHARLESTON BLVD STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1669
Practice Address - Country:US
Practice Address - Phone:702-396-4165
Practice Address - Fax:702-252-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8442207RI0200X
NV11377207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018228Medicaid
NV100506333Medicaid
NV100506943Medicaid
NV100506333Medicaid
NVV100450Medicare PIN
NVH31059Medicare UPIN
NV002018228Medicaid
NVV100484Medicare PIN