Organization
INTERNAL MEDICINE CLINIC BANERJI LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASHAB BANERJI MD (OWNER)
(702) 740-5311
Entity
Organization
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
261QP2300X
Primary Care Clinic/Center
Primary
9544
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD5081
RAILROAD MEDICARE
NV
Enumeration date
08/31/2006
Last updated
07/03/2019
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