Provider Demographics
NPI:1437210002
Name:CHAUDHERY, ISMAT GULZAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ISMAT
Middle Name:GULZAR
Last Name:CHAUDHERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 N TENAYA WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1404
Mailing Address - Country:US
Mailing Address - Phone:702-255-0500
Mailing Address - Fax:
Practice Address - Street 1:7580 W SAHARA AVE FL 2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2742
Practice Address - Country:US
Practice Address - Phone:702-255-0500
Practice Address - Fax:702-821-1704
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7837208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003119912Medicaid
NV002019912Medicaid
NV003119912Medicaid
NV002019912Medicaid