Provider Demographics
NPI:1407028426
Name:BISHR HIJAZI MD INC
Entity Type:Organization
Organization Name:BISHR HIJAZI MD INC
Other - Org Name:THE HAND & WRIST SPECIALTY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-233-4100
Mailing Address - Street 1:4982 SOUTH RAINBOW BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1111
Mailing Address - Country:US
Mailing Address - Phone:702-233-4100
Mailing Address - Fax:702-233-9002
Practice Address - Street 1:4982 SOUTH RAINBOW BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1111
Practice Address - Country:US
Practice Address - Phone:702-233-4100
Practice Address - Fax:702-233-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV122982086S0105X
NVC20110322-1075261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1235338641Medicaid
NV1407028426Medicaid