Provider Demographics
NPI:1629242698
Name:DIGESTIVE ASSOCIATES LLP
Entity Type:Organization
Organization Name:DIGESTIVE ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RANADEV
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKHERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-204-0435
Mailing Address - Street 1:2031 MCDANIEL ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6303
Mailing Address - Country:US
Mailing Address - Phone:702-633-0207
Mailing Address - Fax:702-633-5099
Practice Address - Street 1:2031 MCDANIEL ST
Practice Address - Street 2:SUITE 210
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6303
Practice Address - Country:US
Practice Address - Phone:702-633-0207
Practice Address - Fax:702-633-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9886207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1007232420OtherNV STATE BUSINESS LICENSE