Healthcare Provider Details

I. General information

NPI: 1164484440
Provider Name (Legal Business Name): AFROZE A AHMAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 08/29/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3514 N POWER RD STE 107
MESA AZ
85215-2907
US

IV. Provider business mailing address

3514 N POWER RD STE 107
MESA AZ
85215-2907
US

V. Phone/Fax

Practice location:
  • Phone: 480-361-9949
  • Fax: 480-361-9969
Mailing address:
  • Phone: 480-361-9949
  • Fax: 480-361-9969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number26189
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberCDR.0004201
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number26189
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: