Provider Demographics
NPI:1649269606
Name:RANGA, VISHWESHWAR (MD)
Entity type:Individual
Prefix:
First Name:VISHWESHWAR
Middle Name:
Last Name:RANGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2645 PARIS AMOUR ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0333
Mailing Address - Country:US
Mailing Address - Phone:702-649-8009
Mailing Address - Fax:702-649-8049
Practice Address - Street 1:1700 E DESERT INN RD STE 301
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169
Practice Address - Country:US
Practice Address - Phone:702-649-8009
Practice Address - Fax:702-649-8049
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9296207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV100660Medicare PIN