MEDICARE: SHIRLEY ANNETTE NAJJAR M.D.

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	207Q00000X	Family Medicine Physician	4301101748	MI
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207Q00000X	Family Medicine Physician	20178	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
2	20178	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1245523349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRLEY ANNETTE NAJJAR M.D.

Provider Business Mailing Address
First Line	:	6355 S BUFFALO DR FL 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2133
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:	702-671-6883

Provider Business Practice Location Address
First Line	:	5320 S RAINBOW BLVD STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1807
Country	:	US
Telephone Number	:	702-944-7105
Fax Number	:	702-944-7110

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

Provider Enumeration Date	:	05/23/2011
Last Update Date	:	04/13/2023

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