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NPI Code Detail

MEDICARE: ABDUL-SAMI FAWAD SIDDIQUI M.D.

MEDICARE: ABDUL-SAMI FAWAD SIDDIQUI 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
1174400000XSpecialist8548NV
2207R00000XInternal Medicine Physician8548NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110236074OTHERRAILROAD CARRIER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558463836
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABDUL-SAMI FAWAD SIDDIQUI M.D.
Provider Business Mailing Address
First Line : 3540 W SAHARA AVE
Second Line : SUITE 330
City : LAS VEGAS
State : NV
Zip : 89102-5816
Country : US
Telephone Number : 702-921-6823
Fax Number : 702-549-5240
Provider Business Practice Location Address
First Line : 9300 W SUNSET RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-4844
Country : US
Telephone Number : 702-921-6823
Fax Number : 702-549-5240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2006
Last Update Date : 10/07/2016

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