Provider Demographics
NPI:1649478314
Name:AMMAR, TAREK (MD)
Entity type:Individual
Prefix:DR
First Name:TAREK
Middle Name:
Last Name:AMMAR
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 1:8530 W SUNSET RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2215
Mailing Address - Country:US
Mailing Address - Phone:702-483-4483
Mailing Address - Fax:702-483-4493
Practice Address - Street 1:8530 W SUNSET RD
Practice Address - Street 2:SUITE 230
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2215
Practice Address - Country:US
Practice Address - Phone:702-483-4483
Practice Address - Fax:702-483-4493
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT10702453-1205207RG0100X
NV13527207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500484 GROUPMedicaid
NVDQ631ZMedicare PIN
NV100500484 GROUPMedicaid