MEDICARE: SOUTHERN NEVADA BARIATRICS MUSTAFA AHMED MD FACS PLLC

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	2086S0102X	Surgical Critical Care Physician	15815	NV
2	208600000X	Surgery Physician	15815	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15815	OTHER	NV	NV MEDICAL LICENSE

General Provider Information

NPI Number	:	1821450545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN NEVADA BARIATRICS MUSTAFA AHMED MD FACS PLLC

Provider Business Mailing Address
First Line	:	2990 W HORIZON RIDGE PKWY STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4663
Country	:	US
Telephone Number	:	702-626-0499
Fax Number	:	702-629-5038

Provider Business Practice Location Address
First Line	:	2990 W HORIZON RIDGE PKWY STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4663
Country	:	US
Telephone Number	:	702-626-0499
Fax Number	:	702-629-5038

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MUSTAFA I AHMED
Credential	:	MD
Telephone Number	:	702-626-0499

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/19/2025

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