Provider Demographics
NPI:1225026016
Name:DARBARI, SHABNAM (MD)
Entity type:Individual
Prefix:
First Name:SHABNAM
Middle Name:
Last Name:DARBARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36830
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6830
Mailing Address - Country:US
Mailing Address - Phone:702-655-1400
Mailing Address - Fax:702-685-0612
Practice Address - Street 1:2600 S RAINBOW BLVD
Practice Address - Street 2:#108
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-4006
Practice Address - Country:US
Practice Address - Phone:702-655-1400
Practice Address - Fax:702-685-0612
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10032207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV00 2018578Medicaid
H65262Medicare UPIN
NV00 2018578Medicaid