Individual
DR. RAGHAVENDRA MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1701 N GREEN VALLEY PKWY STE 4C, HENDERSON, NV 89074-5886
(702) 508-9119
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
(702) 838-1456
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18858
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006718900
—
FL
01
—
024212
KAISER COMMERCIAL NUMBER
CO
05
—
97188069
—
CO
Enumeration date
11/06/2008
Last updated
06/02/2024
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