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NPI Code Detail

MEDICARE: MUJEEB UDDIN SHAD MD

MEDICARE: MUJEEB UDDIN SHAD 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
12084A0401XAddiction Medicine (Psychiatry & Neurology) Physician20009NV
22084P0800XPsychiatry Physician036-132238IL
32084P0800XPsychiatry Physician20009NV

Other Identifiers

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

General Provider Information

NPI Number : 1871519041
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUJEEB UDDIN SHAD MD
Provider Business Mailing Address
First Line : 10624 S EASTERN AVE STE A-955
Second Line :
City : HENDERSON
State : NV
Zip : 89052-2982
Country : US
Telephone Number :
Fax Number : 24-077-0167
Provider Business Practice Location Address
First Line : 5400 S RAINBOW BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1859
Country : US
Telephone Number : 702-853-3000
Fax Number : 702-385-3073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 12/18/2024

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Directions to “ MUJEEB UDDIN SHAD MD” Practice Location

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