Provider Demographics
NPI:1609891514
Name:HAMZA, HADIZA (MD)
Entity type:Individual
Prefix:
First Name:HADIZA
Middle Name:
Last Name:HAMZA
Suffix:
Gender:F
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:PO BOX 50878
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89016-0878
Mailing Address - Country:US
Mailing Address - Phone:702-805-5410
Mailing Address - Fax:702-342-1385
Practice Address - Street 1:1730 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-1000
Practice Address - Country:US
Practice Address - Phone:702-805-5410
Practice Address - Fax:702-342-1385
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10125207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500281Medicaid
NVV106133Medicare PIN
NVH69247Medicare UPIN