Provider Demographics
NPI:1750330726
Name:TARIQ, NADEEM (MD)
Entity Type:Individual
Prefix:
First Name:NADEEM
Middle Name:
Last Name:TARIQ
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 1:1930 VILLAGE CENTER CIR
Mailing Address - Street 2:3-434
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6299
Mailing Address - Country:US
Mailing Address - Phone:702-921-6823
Mailing Address - Fax:702-921-6821
Practice Address - Street 1:2600 S RAINBOW BLVD
Practice Address - Street 2:#108
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-4006
Practice Address - Country:US
Practice Address - Phone:702-921-6823
Practice Address - Fax:702-921-6821
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10625207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500792Medicaid
NVBT8323812OtherDEA
38187Medicare ID - Type Unspecified
NVBT8323812OtherDEA