MEDICARE: DR. MALIK TARIQ RAHIM 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	207RC0000X	Cardiovascular Disease Physician	14371	NV
2	207RI0011X	Interventional Cardiology Physician	14371	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	:	1356542112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALIK TARIQ RAHIM M.D.

Provider Business Mailing Address
First Line	:	10170 W TROPICANA AVE # 156-336
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8465
Country	:	US
Telephone Number	:	702-659-7822
Fax Number	:	702-659-7805

Provider Business Practice Location Address
First Line	:	2755 SILVER CREEK RD
Second Line	:	SUITE 217
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7904
Country	:	US
Telephone Number	:	928-704-6070
Fax Number	:	928-704-4736

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	08/29/2020

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