Provider Demographics
NPI:1285672816
Name:WAHAB, NAZ (MD)
Entity Type:Individual
Prefix:
First Name:NAZ
Middle Name:
Last Name:WAHAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6070 S FORT APACHE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5615
Mailing Address - Country:US
Mailing Address - Phone:702-803-5534
Mailing Address - Fax:702-803-5534
Practice Address - Street 1:6070 S FORT APACHE RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5615
Practice Address - Country:US
Practice Address - Phone:702-803-5534
Practice Address - Fax:702-803-5534
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV10656207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101560Medicare PIN