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NPI Code Detail

MEDICARE: BADRUNNISA HANIF MD PC

MEDICARE: BADRUNNISA HANIF 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
1208M00000XHospitalist Physician
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1245401793
Entity Type Code : Organization
Provider Name (Legal Business Name) : BADRUNNISA HANIF MD PC
Provider Business Mailing Address
First Line : PO BOX 400937
Second Line :
City : LAS VEGAS
State : NV
Zip : 89140-0937
Country : US
Telephone Number : 702-791-1222
Fax Number : 702-735-9074
Provider Business Practice Location Address
First Line : 5495 S RAINBOW BLVD STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1872
Country : US
Telephone Number : 702-791-1222
Fax Number : 702-735-9074
Authorized Official
Title or Position : PRESIDENT
Name : BADRUNNISA I HANIF
Credential : MD
Telephone Number : 702-214-9741
Provider Enumeration Date : 03/12/2008
Last Update Date : 08/05/2010

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