MEDICARE: SYED IRSHAD PERVAIZ M.D.

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	11875	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	:	1326079096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED IRSHAD PERVAIZ M.D.

Provider Business Mailing Address
First Line	:	4161 S EASTERN AVE
Second Line	:	SUITE # B3
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5484
Country	:	US
Telephone Number	:	702-693-6222
Fax Number	:	702-369-6504

Provider Business Practice Location Address
First Line	:	4161 S EASTERN AVE
Second Line	:	SUITE # B3
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5484
Country	:	US
Telephone Number	:	702-693-6222
Fax Number	:	702-369-6504

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	05/02/2023

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