Basic Information
Provider Information
NPI: 1104280783
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAHMAN
FirstName: AADIL
MiddleName: MOHAMMED
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherLastNameType:  
Mailing Information
Address1: 401 N. BUFFALO DR
Address2: SUITE 200
City: LAS VEGAS
State: NV
PostalCode: 891450397
CountryCode: US
TelephoneNumber: 7026970082
FaxNumber: 7026919984
Practice Location
Address1: 3186 S. MARYLAND PARKWAY
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891092317
CountryCode: US
TelephoneNumber: 7029618181
FaxNumber: 7029617819
Other Information
ProviderEnumerationDate: 04/08/2016
LastUpdateDate: 08/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XDO2605NVY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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