Individual
MIRELA C MALEVANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
715 MALL RING CIR, HENDERSON, NV 89014-6665
(702) 483-6200
(702) 483-6202
Mailing address
715 MALL RING CIR, HENDERSON, NV 89014-6665
(702) 483-6200
(702) 483-6202
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11177
NV
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
11177
NV
207RP1001X
Pulmonary Disease Physician
11177
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM717Z
NVCC-PTAN
NV
01
—
V102803
PTAN
NV
Enumeration date
05/04/2006
Last updated
01/07/2019
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