Healthcare Provider Details

I. General information

NPI: 1316148653
Provider Name (Legal Business Name): FIRAS MARAYATI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5777 E MAYO BLVD
PHOENIX AZ
85054-4502
US

IV. Provider business mailing address

2149 E WARNER RD STE 101
TEMPE AZ
85284-3495
US

V. Phone/Fax

Practice location:
  • Phone: 148-051-5629
  • Fax:
Mailing address:
  • Phone: 480-610-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number37014
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number37014
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: