MEDICARE: FARIDA KHAN-SEWANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	9753	NV
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	9753	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154319929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARIDA KHAN-SEWANI MD

Provider Business Mailing Address
First Line	:	2809 CRYSTAL BEACH DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-6908
Country	:	US
Telephone Number	:	702-858-7376
Fax Number	:	702-685-0612

Provider Business Practice Location Address
First Line	:	2600 S RAINBOW BLVD
Second Line	:	#108
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-4006
Country	:	US
Telephone Number	:	702-655-1400
Fax Number	:	702-685-0612

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	12/15/2009

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