Provider Demographics
NPI:1063587459
Name:AHMAD, SHAMOON (MD)
Entity type:Individual
Prefix:MR
First Name:SHAMOON
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:702-363-2020
Mailing Address - Fax:702-792-4030
Practice Address - Street 1:3340 TOPAZ ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3903
Practice Address - Country:US
Practice Address - Phone:702-363-2020
Practice Address - Fax:702-792-4030
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8655207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVF60009Medicare UPIN
NVV100822Medicare ID - Type Unspecified