Basic Information
Provider Information
NPI: 1184034852
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAFIZ
FirstName: MOHAMMED
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ABDEL HAFIZ
OtherFirstName: MOHAMMED
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D
OtherLastNameType: 5
Mailing Information
Address1: 350 W THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850134409
CountryCode: US
TelephoneNumber: 6024063322
FaxNumber: 6022945090
Practice Location
Address1: 1111 E MCDOWELL RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850062612
CountryCode: US
TelephoneNumber: 6028392000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/05/2014
LastUpdateDate: 08/21/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X378727AZY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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