Basic Information
| Provider Information | |||||||||
| NPI: | 1407240716 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAWOOD | ||||||||
| FirstName: | MOIZ | ||||||||
| MiddleName: | MOHAMMAD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 E CAMELBACK RD STE 180 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850182396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6027596883 | ||||||||
| FaxNumber: | 6022243315 | ||||||||
| Practice Location | |||||||||
| Address1: | 3320 N 2ND ST | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850122319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022008288 | ||||||||
| FaxNumber: | 6022008627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2015 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | MO2021-0309 | NM | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | MD2021-0309 | NM | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | NM | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RN0300X | 67807 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.