Mamidi, Dheeresh Kumar
Mamidi, Dheeresh Kumar is an individual health care provider with primary practice located at 5575 S Durango Dr Ste 103 , Las Vegas NV 89113-1834. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Mamidi, Dheeresh Kumar can be contacted via phone (702) 435-5437.Contact Information
Primary practice address
5575 S Durango Dr Ste 103
Las Vegas NV 89113-1834
Phone: (702) 435-5437
Fax: (702) 851-9640
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 12531 | Nevada |
Profile Details
| NPI number | 1518161181 |
|---|---|
| LBN Legal business name | Mamidi, Dheeresh Kumar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2007 |
| Last updated | Nov 3rd, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518161181 | NPPES |
| Nevada | MEDICAID | 1518161181 |
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