Provider Demographics
NPI:1942403365
Name:LUBNA AHMAD MD PC
Entity Type:Organization
Organization Name:LUBNA AHMAD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUBNA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-228-5000
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
Practice Address - Country:US
Practice Address - Phone:702-228-5000
Practice Address - Fax:702-228-5075
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUBNA AHMAD MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-06
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8670207RE0101X
NV8655207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018016Medicaid
NV002018201Medicaid
NVV100822Medicare PIN
NVG59427Medicare UPIN
NV002018016Medicaid