Healthcare Provider Details

I. General information

NPI: 1578328068
Provider Name (Legal Business Name): NASSIM HADDAD MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13253 N LA MONTANA DR
FOUNTAIN HILLS AZ
85268-8401
US

IV. Provider business mailing address

10101 N 92ND ST STE 101
SCOTTSDALE AZ
85258-4553
US

V. Phone/Fax

Practice location:
  • Phone: 480-747-6532
  • Fax: 480-889-6865
Mailing address:
  • Phone: 480-747-6532
  • Fax: 480-889-6865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NASSIM HADDAD
Title or Position: MEMBER MANAGER
Credential:
Phone: 480-747-6532