Provider Demographics
NPI:1679648463
Name:AHMAD, LUBNA (MD)
Entity Type:Individual
Prefix:MRS
First Name:LUBNA
Middle Name:
Last Name:AHMAD
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 60327
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89160-0327
Mailing Address - Country:US
Mailing Address - Phone:702-228-5000
Mailing Address - Fax:702-228-5075
Practice Address - Street 1:7010 SMOKE RANCH ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0481
Practice Address - Country:US
Practice Address - Phone:702-228-5000
Practice Address - Fax:702-228-5075
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8670207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG59427Medicare UPIN
NVV100822Medicare ID - Type Unspecified