Healthcare Provider Details

I. General information

NPI: 1962467845
Provider Name (Legal Business Name): FAROOQ MUNIR SHAIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 S CIMARRON RD STE B5
LAS VEGAS NV
89145-2454
US

IV. Provider business mailing address

PO BOX 370520
LAS VEGAS NV
89137-0520
US

V. Phone/Fax

Practice location:
  • Phone: 702-749-8885
  • Fax: 702-749-6393
Mailing address:
  • Phone: 702-909-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number182667
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: