Individual
RUTU S EZHUTHACHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119-7826
(702) 737-1880
(702) 259-4634
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 560-2879
(702) 560-2928
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10466
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730159815
—
NV
05
—
2018853
—
NV
05
—
3102853
—
NV
Enumeration date
01/23/2006
Last updated
06/10/2011
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