MEDICARE: PREMIERE PHYSICIANS NETWORK LLP

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	208M00000X	Hospitalist Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1508194473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIERE PHYSICIANS NETWORK LLP

Provider Business Mailing Address
First Line	:	1401 PINE LEAF DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-1648
Country	:	US
Telephone Number	:	702-380-2377
Fax Number	:	702-492-1728

Provider Business Practice Location Address
First Line	:	1401 PINE LEAF DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-1648
Country	:	US
Telephone Number	:	702-380-2377
Fax Number	:	702-492-1728

Authorized Official
Title or Position	:	MNG MBR
Name	:	MUHAMMAD A SYED
Credential	:	MD
Telephone Number	:	702-380-2377

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	12/03/2009

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Directions to “PREMIERE PHYSICIANS NETWORK LLP ” Practice Location

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