Provider Demographics
NPI:1639243538
Name:SBAIH, SAMEERA (MD)
Entity Type:Individual
Prefix:
First Name:SAMEERA
Middle Name:
Last Name:SBAIH
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:PO BOX 531473
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89053-1473
Mailing Address - Country:US
Mailing Address - Phone:702-489-4500
Mailing Address - Fax:702-489-4600
Practice Address - Street 1:2649 WIGWAM PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7367
Practice Address - Country:US
Practice Address - Phone:702-486-4500
Practice Address - Fax:702-489-4600
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11954207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1639243538Medicaid
NVCG743ZMedicare PIN