Individual
KUSH MODI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1707 W CHARLESTON BLVD STE 270, LAS VEGAS, NV 89102-2351
(027) 485-4400
(702) 485-4405
Mailing address
3016 W CHARLESTON BLVD STE 100, LAS VEGAS, NV 89102-1973
(702) 780-7118
(702) 895-4014
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
15940
NV
207RP1001X
Pulmonary Disease Physician
Primary
15940
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780998518
—
NV
Enumeration date
08/04/2010
Last updated
06/15/2022
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