Healthcare Provider Details

I. General information

NPI: 1871652768
Provider Name (Legal Business Name): ANIS ABI-KARAM LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 11/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 S JONES BLVD
LAS VEGAS NV
89146-5306
US

IV. Provider business mailing address

2740 S JONES BLVD
LAS VEGAS NV
89146-5306
US

V. Phone/Fax

Practice location:
  • Phone: 702-248-8866
  • Fax: 702-248-1339
Mailing address:
  • Phone: 702-248-8866
  • Fax: 702-248-1339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberPY173
License Number StateNV

VIII. Authorized Official

Name: DR. ANIS SALIM ABI-KARAN
Title or Position: PRESIDENT
Credential: PHD
Phone: 702-248-8866