Basic Information
| Provider Information | |||||||||
| NPI: | 1174939623 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BILAL | ||||||||
| FirstName: | JAWAD | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 N CAMPBELL AVE RM 8339 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857240001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206264111 | ||||||||
| FaxNumber: | 5206264171 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 N CAMPBELL AVE RM 8339 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206264111 | ||||||||
| FaxNumber: | 5206264171 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2014 | ||||||||
| LastUpdateDate: | 06/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 54852 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.