Individual
CHAKRAVARTHY R KANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5701 W CHARLESTON BLVD STE 100, LAS VEGAS, NV 89146-1256
(702) 877-9514
(702) 312-3510
Mailing address
5701 W CHARLESTON BLVD STE 100, LAS VEGAS, NV 89146-1256
(702) 877-9514
(702) 312-3510
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
8526
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100501334
—
NV
Enumeration date
01/31/2006
Last updated
06/22/2021
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