Provider Demographics
NPI:1598757536
Name:FATHIE, AREZO M (MD)
Entity Type:Individual
Prefix:DR
First Name:AREZO
Middle Name:M
Last Name:FATHIE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5135 S DURANGO DR
Mailing Address - Street 2:#102
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0190
Mailing Address - Country:US
Mailing Address - Phone:702-407-9994
Mailing Address - Fax:702-407-9998
Practice Address - Street 1:5135 S. DURANGO DR
Practice Address - Street 2:SUITE 102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:702-407-9994
Practice Address - Fax:702-407-9998
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2016-11-01
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Provider Licenses
StateLicense IDTaxonomies
NV8750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2019177Medicaid
NVG97284Medicare UPIN
NV2019177Medicaid