Healthcare Provider Details

I. General information

NPI: 1629026794
Provider Name (Legal Business Name): WASEEM AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N PECOS RD
NORTH LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

12575 FIELDCREEK LN
RENO NV
89511-6633
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-9000
  • Fax: 859-236-6754
Mailing address:
  • Phone: 859-583-8224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberKY33677
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number33677
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: