MEDICARE: AHN, ABDULLA & KRISHNAN, M.D., LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician		NV

General Provider Information

NPI Number	:	1073592309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHN, ABDULLA & KRISHNAN, M.D., LTD

Provider Business Mailing Address
First Line	:	5586 S FORT APACHE RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-7682
Country	:	US
Telephone Number	:	702-384-8099
Fax Number	:	702-384-3930

Provider Business Practice Location Address
First Line	:	5586 S FORT APACHE RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-7682
Country	:	US
Telephone Number	:	702-384-8099
Fax Number	:	702-384-3930

Authorized Official
Title or Position	:	PRESIDENT/PHYSICIAN
Name	:	FAROOQ ABDULLA
Credential	:	M.D.
Telephone Number	:	702-384-8099

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	09/28/2009

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