Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 12845 | NV |
N | 207RN0300X | Nephrologist | 35082124 | OH |
N | 207RN0300X | Nephrologist | TP512 | KY |
NPI | 1003854597 |
---|---|
Provider Name | Rahul Navin Mediwala |
First Address | Reno, NV 89502-0845 |
Second Address | Reno, NV 89502-1262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 23/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11557200 | CAQH (01) | |
I52661 | (02) |