Provider Demographics
NPI:1972814093
Name:DUGGAL, SEJAL A (MD)
Entity type:Individual
Prefix:
First Name:SEJAL
Middle Name:A
Last Name:DUGGAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SEJAL
Other - Middle Name:A
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:2035 VILLAGE CENTER CIR # 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6251
Practice Address - Country:US
Practice Address - Phone:702-228-7117
Practice Address - Fax:702-804-5365
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV15326OtherSTATE LICENSE
NV1972814093Medicaid
NV1972814093Medicaid
KYKO20702Medicare PIN
KYK020700Medicare PIN
KYK020701Medicare PIN