Healthcare Provider Details

I. General information

NPI: 1144474214
Provider Name (Legal Business Name): HIKMAT N DAGER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2008
Last Update Date: 11/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W CHARLESTON BLVD
LAS VEGAS NV
89102-2127
US

IV. Provider business mailing address

DEPT 8264
LOS ANGELES CA
90084-0001
US

V. Phone/Fax

Practice location:
  • Phone: 702-382-7760
  • Fax: 702-382-7871
Mailing address:
  • Phone: 702-407-8241
  • Fax: 702-492-1728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number12664
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number12664
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number11664
License Number StateNV

VIII. Authorized Official

Name: HIKMAT NICHOLAS DAGHER
Title or Position: PRESIDENT
Credential: MD
Phone: 702-875-1293