MEDICARE: HIKMAT N DAGER MD PC

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	12664	NV
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	12664	NV
3	207RP1001X	Pulmonary Disease Physician	11664	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144474214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIKMAT N DAGER MD PC

Provider Business Mailing Address
First Line	:	DEPT 8264
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90084-0001
Country	:	US
Telephone Number	:	702-407-8241
Fax Number	:	702-492-1728

Provider Business Practice Location Address
First Line	:	2501 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2127
Country	:	US
Telephone Number	:	702-382-7760
Fax Number	:	702-382-7871

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HIKMAT NICHOLAS DAGHER
Credential	:	MD
Telephone Number	:	702-875-1293

Provider Enumeration Date	:	11/15/2008
Last Update Date	:	11/12/2009

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