Healthcare Provider Details

I. General information

NPI: 1861746935
Provider Name (Legal Business Name): SAMIR S HADI MBCHB
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SAMIR S HADI-TAMIMI MBCHB

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 E FLAMINGO RD
LAS VEGAS NV
89119-5170
US

IV. Provider business mailing address

2250 E FLAMINGO RD
LAS VEGAS NV
89119-5170
US

V. Phone/Fax

Practice location:
  • Phone: 607-242-9241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number036173564
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036173564
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number18477
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number72016
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD461320
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberPENDING
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: