MEDICARE: MOHAMAD MUBDER

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	19686	NV

General Provider Information

NPI Number	:	1710428156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMAD MUBDER

Provider Business Mailing Address
First Line	:	1701 W CHARLESTON BLVD STE 230
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2312
Country	:	US
Telephone Number	:	702-671-2341
Fax Number	:	702-671-2376

Provider Business Practice Location Address
First Line	:	1701 W CHARLESTON BLVD STE 230
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2312
Country	:	US
Telephone Number	:	702-671-2341
Fax Number	:	702-671-2376

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

Provider Enumeration Date	:	03/18/2017
Last Update Date	:	08/11/2020

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Directions to “ MOHAMAD MUBDER ” Practice Location

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