Provider Demographics
NPI:1386744266
Name:BADERY, AHMAD FARID (MD)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:FARID
Last Name:BADERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1350 E FLAMINGO RD
Mailing Address - Street 2:#174
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5263
Mailing Address - Country:US
Mailing Address - Phone:702-380-2048
Mailing Address - Fax:702-968-8637
Practice Address - Street 1:2470 E FLAMINGO RD
Practice Address - Street 2:SUITE # D
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5200
Practice Address - Country:US
Practice Address - Phone:702-380-2048
Practice Address - Fax:702-968-8637
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV11481208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506784Medicaid
NV100506784Medicaid