Healthcare Provider Details

I. General information

NPI: 1174439376
Provider Name (Legal Business Name): NAUMAN IDREES MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 E MAYO BLVD
PHOENIX AZ
85054-4504
US

IV. Provider business mailing address

5881 E MAYO BLVD
PHOENIX AZ
85054-4504
US

V. Phone/Fax

Practice location:
  • Phone: 623-703-7450
  • Fax: 480-342-2324
Mailing address:
  • Phone: 480-301-6990
  • Fax: 480-342-2324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberR82861
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: