Individual
BUDDHADEB DAWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1707 W CHARLESTON BLVD STE 230, LAS VEGAS, NV 89102-2353
(702) 671-2201
Mailing address
3016 W CHARLESTON BLVD, STE 100, LAS VEGAS, NV 89102-1973
(702) 218-0915
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
04-34507
KS
207RC0000X
Cardiovascular Disease Physician
Primary
18127
NV
207RC0000X
Cardiovascular Disease Physician
2010030195
MO
207RC0000X
Cardiovascular Disease Physician
33219
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528043460
—
MO
05
—
1528043460
—
NV
05
—
200679520A
—
KS
01
—
V55871
MEDICARE
NV
Enumeration date
12/14/2005
Last updated
04/27/2021
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