Healthcare Provider Details

I. General information

NPI: 1760778906
Provider Name (Legal Business Name): MAAZ IQBAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2572 E ATHENA AVE
GILBERT AZ
85297-0216
US

IV. Provider business mailing address

2572 E ATHENA AVE
GILBERT AZ
85297-0216
US

V. Phone/Fax

Practice location:
  • Phone: 480-375-5056
  • Fax:
Mailing address:
  • Phone: 480-375-5056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR72526
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number52281
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number52281
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: