Individual
SMITHA MUTHIALU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4475 S EASTERN, LAS VEGAS, NV 89119
(702) 737-1880
(702) 650-0763
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 737-1880
(702) 650-0763
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9869
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447223839
—
NV
05
—
2018444
—
NV
05
—
3102444
—
NV
Enumeration date
02/08/2006
Last updated
02/14/2014
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