Basic Information
| Provider Information | |||||||||
| NPI: | 1245229400 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WATTOO | ||||||||
| FirstName: | DOST | ||||||||
| MiddleName: | MUHAMMAD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 SHADOW LN | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891064158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023840022 | ||||||||
| FaxNumber: | 7023840529 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 SHADOW LN | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891064158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023840022 | ||||||||
| FaxNumber: | 7023840529 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2005 | ||||||||
| LastUpdateDate: | 09/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 09/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 3519 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 20-02923 | 05 | NV | MEDICAID | 2002983 | 05 | NV | MEDICAID |