Healthcare Provider Details

I. General information

NPI: 1003602590
Provider Name (Legal Business Name): FAHMEEDA AWAN MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2025
Last Update Date: 04/19/2025
Certification Date: 04/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5882 S HOSPITAL DR STE 1
GLOBE AZ
85501-9455
US

IV. Provider business mailing address

5882 S HOSPITAL DR STE 1
GLOBE AZ
85501-9455
US

V. Phone/Fax

Practice location:
  • Phone: 928-793-3747
  • Fax: 928-793-3745
Mailing address:
  • Phone: 928-793-3747
  • Fax: 928-793-3745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberR81474
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: