1013085257 NPI number — DR. MUHAMMED A HYDER MD

Table of content: DR. MUHAMMED A HYDER MD (NPI 1013085257)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013085257 NPI number — DR. MUHAMMED A HYDER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HYDER
Provider First Name:
MUHAMMED
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALI
Provider Other First Name:
MUHAHHAD
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013085257
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2248 VIA CADOMA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89052-7817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-208-2988
Provider Business Mailing Address Fax Number:
304-522-0686

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2465 E TWAIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89121-4011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-789-6201
Provider Business Practice Location Address Fax Number:
304-522-0686
Provider Enumeration Date:
12/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  21858 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084A0401X , with the licence number: 13930 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3810002247 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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