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NPI Code Detail

MEDICARE: DR. MARWAN M BAHU M.D.

MEDICARE: DR. MARWAN M BAHU M.D.
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
1207RC0001XClinical Cardiac Electrophysiology Physician25435AZ
2174400000XSpecialist25435AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4060046890OTHERAZMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0819030OTHERAZBCBS AZ
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
35124540OTHERAZAETNA

General Provider Information

NPI Number : 1114920618
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARWAN M BAHU M.D.
Provider Business Mailing Address
First Line : 2777 E CAMELBACK RD STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-4352
Country : US
Telephone Number : 602-952-0002
Fax Number : 602-778-4565
Provider Business Practice Location Address
First Line : 2777 E CAMELBACK RD STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-4352
Country : US
Telephone Number : 602-952-0002
Fax Number : 602-224-9119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 05/10/2021

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