Provider Demographics
NPI:1740352699
Name:DEWAN, ASHEESH KUMAR (MD)
Entity type:Individual
Prefix:
First Name:ASHEESH
Middle Name:KUMAR
Last Name:DEWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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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 1:8352 W WARM SPRINGS RD FL 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3628
Practice Address - Country:US
Practice Address - Phone:702-851-7287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV121302080P0205X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100511272Medicaid
NVH98214Medicare UPIN