MEDICARE: FAWAD AHMED

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	207R00000X	Internal Medicine Physician	9524	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	:	1174571723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAWAD AHMED

Provider Business Mailing Address
First Line	:	9044 THORNBURY LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6169
Country	:	US
Telephone Number	:	702-945-2370
Fax Number	:	702-924-6140

Provider Business Practice Location Address
First Line	:	700 E WARM SPRINGS RD
Second Line	:	#100
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4305
Country	:	US
Telephone Number	:	702-216-3350
Fax Number	:	702-216-3356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/02/2017

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Directions to “ FAWAD AHMED ” Practice Location

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