MEDICARE: AHMAD FARID BADERY, MD, P.C.

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	11481	NV

General Provider Information

NPI Number	:	1962666305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHMAD FARID BADERY, MD, P.C.

Provider Business Mailing Address
First Line	:	1350 E FLAMINGO RD
Second Line	:	STE 174
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5226
Country	:	US
Telephone Number	:	702-544-3849
Fax Number	:

Provider Business Practice Location Address
First Line	:	2470 E FLAMINGO RD
Second Line	:	#D
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5200
Country	:	US
Telephone Number	:	702-544-3849
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AHMAD FARID BADERY
Credential	:	MD
Telephone Number	:	702-544-3849

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	06/03/2009

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