Provider Demographics
NPI:1588632285
Name:NAJJAR, FADI (MD)
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:
Last Name:NAJJAR
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 1:850 HARVARD WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2055
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:1500 E 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1196
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-3356
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12893207RN0300X, 207RN0300X
ORMD25425207R00000X, 207RN0300X
WAMD00043508207RN0300X
PAMD419777207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1588632285Medicaid
11487787OtherCAQH
NV1588632285Medicaid
NVBA606ZMedicare PIN
NVBA606ZMedicare PIN
NV1588632285Medicaid
WA8415697Medicaid
H96535Medicare UPIN
OR277864Medicaid
PA074481V3LMedicare PIN
ORR130645Medicare PIN