Provider Demographics
NPI:1467731505
Name:SHAMIYA, MOHAMED (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:SHAMIYA
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 31299
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89173
Mailing Address - Country:US
Mailing Address - Phone:702-478-8819
Mailing Address - Fax:702-478-7324
Practice Address - Street 1:2400 S CIMARRON RD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7902
Practice Address - Country:US
Practice Address - Phone:702-478-8819
Practice Address - Fax:702-478-7324
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16441207R00000X, 207RS0012X
GA75370207R00000X
SCMD36677207R00000X
CAA145141208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist