Healthcare Provider Details

I. General information

NPI: 1730173204
Provider Name (Legal Business Name): AJAZ A. SHEIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8630 W CHEYENNE AVE
LAS VEGAS NV
89129-7260
US

IV. Provider business mailing address

PO BOX 36009
LAS VEGAS NV
89133-6009
US

V. Phone/Fax

Practice location:
  • Phone: 702-851-9383
  • Fax: 702-851-9380
Mailing address:
  • Phone: 702-659-7796
  • Fax: 702-659-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number11214
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: