Provider Demographics
NPI:1083671010
Name:AFTAB, AMIR (MD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:AFTAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9811 W CHARLESTON BLVD
Mailing Address - Street 2:STE 2-770
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:702-487-7055
Mailing Address - Fax:702-991-7258
Practice Address - Street 1:2250 E FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5170
Practice Address - Country:US
Practice Address - Phone:702-487-7055
Practice Address - Fax:702-727-1522
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11125207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVWQBHVOtherGROUP MEDICARE NUMBER
NV100506713Medicaid
NVI49114Medicare UPIN
NVWQBHV GROUPMedicare PIN
NV101958Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NV101959Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NV101959Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER