Sontuss Bussaratid, M.D.

Individual provider Active NPI Psychiatry Physician · Las Vegas, NV

NPI 1043329162 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043329162
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
10834 (NV)
Practice address
2121 Las Vegas Blvd S
Las Vegas, NV 89104-2544
Phone
(702) 486-5750
Fax
(702) 486-5769
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10834NVMDPsychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 10834 NV Yes

Addresses

Primary practice location

2121 Las Vegas Blvd S
Las Vegas, NV 89104-2544

Mailing address

6161 W Charleston Blvd
Las Vegas, NV 89146-1126
Phone (702) 486-6000

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Psychiatry Physician in Nevada

Sources for this page

Verify at the official NPI Registry.