Provider Demographics
NPI:1790818433
Name:CARULLO, FAUZIA (MD)
Entity Type:Individual
Prefix:DR
First Name:FAUZIA
Middle Name:
Last Name:CARULLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FAUZIA
Other - Middle Name:
Other - Last Name:CHAUDHERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7580 W SAHARA AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2742
Mailing Address - Country:US
Mailing Address - Phone:702-852-2000
Mailing Address - Fax:702-821-1704
Practice Address - Street 1:7580 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2742
Practice Address - Country:US
Practice Address - Phone:702-852-2000
Practice Address - Fax:702-821-1704
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13682207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine