Provider Demographics
NPI:1265577563
Name:ASHEESH DEWAN M D LTD
Entity type:Organization
Organization Name:ASHEESH DEWAN M D LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHEESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:DEWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-851-7287
Mailing Address - Street 1:5235 S DURANGO DR STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0165
Mailing Address - Country:US
Mailing Address - Phone:702-851-7287
Mailing Address - Fax:702-851-7286
Practice Address - Street 1:5235 S DURANGO DR STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0165
Practice Address - Country:US
Practice Address - Phone:702-851-7287
Practice Address - Fax:702-851-7286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV121302080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Single Specialty