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Individual

SUBHASREE PANCHANGAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3131 LA CANADA ST STE 140, LAS VEGAS, NV 89169-2579
(702) 933-9400
(702) 933-9444
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
BP10061062
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
19099
NV
207RC0001X
Clinical Cardiac Electrophysiology Physician
283694
MA
390200000X
Student in an Organized Health Care Education/Training Program
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760809818
NV
01
19099
STATE LICENSE
NV
Enumeration date
03/26/2014
Last updated
03/10/2025
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