Provider Demographics
NPI:1801025119
Name:SIRSY, HESHAM AL (MD)
Entity Type:Individual
Prefix:DR
First Name:HESHAM
Middle Name:AL
Last Name:SIRSY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10950 S EASTERN AVE
Mailing Address - Street 2:100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4970
Mailing Address - Country:US
Mailing Address - Phone:702-614-2192
Mailing Address - Fax:701-614-2190
Practice Address - Street 1:10950 S EASTERN AVE
Practice Address - Street 2:100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4970
Practice Address - Country:US
Practice Address - Phone:702-614-2192
Practice Address - Fax:701-614-2190
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV7291208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV31-02371Medicaid