Healthcare Provider Details

I. General information

NPI: 1083207096
Provider Name (Legal Business Name): JMA INTEGRATED MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 11/18/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 E PECOS RD STE 1
CHANDLER AZ
85225-6072
US

IV. Provider business mailing address

4637 E REINS RD
GILBERT AZ
85297-9515
US

V. Phone/Fax

Practice location:
  • Phone: 480-825-0593
  • Fax:
Mailing address:
  • Phone: 480-313-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HAZEM ABAWI
Title or Position: OWNER
Credential: PHARM D
Phone: 480-313-3600