Individual
CHARLES KIM DANISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10624 S EASTERN AVE # A-955, HENDERSON, NV 89052-2982
(702) 800-5393
(702) 407-7016
Mailing address
10624 S EASTERN AVE # A-955, HENDERSON, NV 89052-2982
(702) 800-5393
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO2479
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540889154
MONTGOMERY REGIONAL HOSPITAL
VA
Enumeration date
04/12/2016
Last updated
07/30/2019
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