Provider Demographics
NPI:1447266739
Name:SHEHANE, RICHARD R (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:SHEHANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:700 E SILVERADO RANCH BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7516
Mailing Address - Country:US
Mailing Address - Phone:702-240-6482
Mailing Address - Fax:702-804-0957
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:SUITE 320
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-240-6482
Practice Address - Fax:702-804-0957
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV6144207RC0000X
LAMD015086207RC0000X
AZ22598207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019061Medicaid
NV103058Medicare PIN
NV002019061Medicaid