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NPI Code Detail

MEDICARE: OMER HAMID WHARTON-ALI MD

MEDICARE:   OMER HAMID WHARTON-ALI  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
1208D00000XGeneral Practice Physician3863NV

General Provider Information

NPI Number : 1750566030
Entity Type Code : Individual
Provider Name (Legal Business Name) : OMER HAMID WHARTON-ALI MD
Provider Business Mailing Address
First Line : PO BOX 364479
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89036-8479
Country : US
Telephone Number : 702-399-3404
Fax Number : 702-399-1819
Provider Business Practice Location Address
First Line : 1703 CIVIC CENTER DR STE 1B
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89030-7273
Country : US
Telephone Number : 702-399-3404
Fax Number : 702-399-1819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2008
Last Update Date : 01/04/2008

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Directions to “ OMER HAMID WHARTON-ALI MD” Practice Location

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