Individual
DR. BASHAB BANERJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5731 S FORT APACHE RD STE 100, LAS VEGAS, NV 89148-5620
(702) 740-5311
(702) 740-5310
Mailing address
5731 SOUTH FORT APACHE ROAD, SUITE A, LAS VEGAS, NV 89148
(702) 740-5311
(702) 740-5310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9544
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018282
—
NV
Enumeration date
07/12/2005
Last updated
07/03/2019
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