Provider Demographics
NPI:1881444826
Name:MOHANADASAN, SUMEGHA (MD)
Entity type:Individual
Prefix:DR
First Name:SUMEGHA
Middle Name:
Last Name:MOHANADASAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 W GILMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7684
Mailing Address - Country:US
Mailing Address - Phone:702-682-5232
Mailing Address - Fax:
Practice Address - Street 1:1701 W CHARLESTON BLVD STE 230
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2312
Practice Address - Country:US
Practice Address - Phone:702-676-3650
Practice Address - Fax:702-676-3635
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program