Individual
RAVISHANKAR S KONCHADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5495 S RAINBOW BLVD STE 101, LAS VEGAS, NV 89118-1872
(702) 477-0772
(702) 477-0486
Mailing address
PO BOX 30077, SALT LAKE CITY, UT 84130-0077
(702) 477-0772
(702) 477-0486
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15389
NV
2085R0202X
Diagnostic Radiology Physician
48477
MN
Other
Enumeration date
05/20/2006
Last updated
10/20/2017
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