Provider Demographics
NPI:1134108038
Name:DAMAJ, NOUHAD (MD)
Entity Type:Individual
Prefix:
First Name:NOUHAD
Middle Name:
Last Name:DAMAJ
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:PO BOX 33166
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-3166
Mailing Address - Country:US
Mailing Address - Phone:702-641-8500
Mailing Address - Fax:702-641-8502
Practice Address - Street 1:6170 N DURANGO DR STE 220
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-3926
Practice Address - Country:US
Practice Address - Phone:702-641-8500
Practice Address - Fax:702-641-8502
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10028207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018451Medicaid
NV002018451Medicaid