Healthcare Provider Details
I. General information
NPI: 1427169986
Provider Name (Legal Business Name): SYED FAIZ RAHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/31/2006
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10410 S EASTERN AVE SUITE #100
HENDERSON NV
89052-4195
US
IV. Provider business mailing address
PO BOX 98820
LAS VEGAS NV
89193-8820
US
V. Phone/Fax
- Phone: 702-914-7150
- Fax: 702-914-1924
- Phone: 702-407-8241
- Fax: 702-492-1728
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 10030 |
| License Number State | NV |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | 10030 |
| License Number State | NV |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | 10030 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: