Healthcare Provider Details

I. General information

NPI: 1427387422
Provider Name (Legal Business Name): SUHA ALI AYOUB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2009
Last Update Date: 07/29/2025
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S DOBSON ROAD
MESA AZ
85202
US

IV. Provider business mailing address

1400 S DOBSON ROAD ATTN BMG HOSPITALIST TEAM/AMANDA GUMP
MESA AZ
85202
US

V. Phone/Fax

Practice location:
  • Phone: 480-412-6788
  • Fax: 480-412-6848
Mailing address:
  • Phone: 480-412-6788
  • Fax: 480-412-6848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR71428
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberR71428
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: