Provider Demographics
NPI:1700816600
Name:CHANDER, KESHAV (MD)
Entity Type:Individual
Prefix:
First Name:KESHAV
Middle Name:
Last Name:CHANDER
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 1:8970 W TROPICANA AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8137
Mailing Address - Country:US
Mailing Address - Phone:702-473-5333
Mailing Address - Fax:702-473-5444
Practice Address - Street 1:8970 W TROPICANA AVE STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8137
Practice Address - Country:US
Practice Address - Phone:702-473-5333
Practice Address - Fax:702-473-5444
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14381207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000063120Medicare PIN