Provider Demographics
NPI:1013085257
Name:HYDER, MUHAMMED A (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMED
Middle Name:A
Last Name:HYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MUHAHHAD
Other - Middle Name:
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2248 VIA CADOMA
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-7817
Mailing Address - Country:US
Mailing Address - Phone:304-208-2988
Mailing Address - Fax:304-522-0686
Practice Address - Street 1:2465 E TWAIN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4011
Practice Address - Country:US
Practice Address - Phone:702-789-6201
Practice Address - Fax:304-522-0686
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV218582084P0800X
NV139302084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810002247Medicaid
G66687Medicare UPIN
NVFM741ZMedicare PIN