Basic Information
| Provider Information | |||||||||
| NPI: | 1225203938 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TANVEER AKBAR MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10620 SOUTHERN HIGHLANDS PKWY | ||||||||
| Address2: | SUITE 110-507 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891414371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029216829 | ||||||||
| FaxNumber: | 7029216828 | ||||||||
| Practice Location | |||||||||
| Address1: | 10620 SOUTHERN HIGHLANDS PKWY | ||||||||
| Address2: | SUITE 110-507 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891414371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029216829 | ||||||||
| FaxNumber: | 7029216828 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2008 | ||||||||
| LastUpdateDate: | 05/28/2010 | ||||||||
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| AuthorizedOfficialLastName: | AKBAR | ||||||||
| AuthorizedOfficialFirstName: | TANVEER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7029216829 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 10973 | NV | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 100505269 | 05 | NV | MEDICAID | 10973 | 01 | NV | MEDICAL LICENSE NUMBER | OTHER |