Basic Information
| Provider Information | |||||||||
| NPI: | 1578727509 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASLAM | ||||||||
| FirstName: | KALEEM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 E CAMELBACK RD | ||||||||
| Address2: | STE 180 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850182396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6027596883 | ||||||||
| FaxNumber: | 6022243315 | ||||||||
| Practice Location | |||||||||
| Address1: | 7301 E 2ND ST STE 118 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852515610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809941238 | ||||||||
| FaxNumber: | 4809949649 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 46986 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 46986 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 809657 | 05 | AZ | MEDICAID |