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NPI Code Detail

MEDICARE: AMJED MARZOUQ ABDELQADER ABDEL AL MD

MEDICARE: AMJED MARZOUQ ABDELQADER ABDEL AL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1043151400
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMJED MARZOUQ ABDELQADER ABDEL AL MD
Provider Business Mailing Address
First Line : 18622 N 28TH WAY # AZ
Second Line :
City : PHOENIX
State : AZ
Zip : 85050-3446
Country : US
Telephone Number : 602-203-4250
Fax Number :
Provider Business Practice Location Address
First Line : 2601 E ROOSEVELT ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4973
Country : US
Telephone Number : 602-344-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2026
Last Update Date : 04/01/2026

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