| Suresh G Prabhu Md Pc | |
|
653 N Town Center Dr 217 Las Vegas NV 89144-0514 | |
| (702) 256-3637 | |
| (702) 256-8510 |
| Full Name | Suresh G Prabhu Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 653 N Town Center Dr, Las Vegas, Nevada |
| Authorized Official Name and Position | Suresh Gopalakrishna Prabhu (OWNER) |
| Authorized Official Contact | 7022563637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suresh G Prabhu Md Pc 653 N Town Center Dr 217 Las Vegas NV 89144-0514 Ph: (702) 256-3637 | Suresh G Prabhu Md Pc 653 N Town Center Dr 217 Las Vegas NV 89144-0514 Ph: (702) 256-3637 |
| NPI Number | 1295757250 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 11/02/2011 |
| Medicare PECOS PAC ID | 1153328877 |
|---|---|
| Medicare Enrollment ID | O20061023000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295757250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 9867 (Nevada) | Primary |
| Provider Name | Suresh G Prabhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730111436 PECOS PAC ID: 3779543657 Enrollment ID: I20041014000962 |
| Provider Name | Mark J Culanag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306489331 PECOS PAC ID: 0648603902 Enrollment ID: I20191127002484 |
| Provider Name | Stacey L Siese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669092367 PECOS PAC ID: 9638582836 Enrollment ID: I20210107001417 |
| Provider Name | Arianne Carisse Reyes Pineda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821852054 PECOS PAC ID: 9032557806 Enrollment ID: I20240329002385 |
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