Provider Demographics
NPI:1861728198
Name:MOHAMMAD, MIR ALI (MD)
Entity type:Individual
Prefix:DR
First Name:MIR
Middle Name:ALI
Last Name:MOHAMMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 N GIBSON RD
Mailing Address - Street 2:STE 311
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1708
Mailing Address - Country:US
Mailing Address - Phone:702-776-8300
Mailing Address - Fax:
Practice Address - Street 1:825 N GIBSON RD STE 311
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1708
Practice Address - Country:US
Practice Address - Phone:702-776-8300
Practice Address - Fax:702-776-8408
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13506207RI0200X
NJ25MA08395100207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease