Healthcare Provider Details

I. General information

NPI: 1598758450
Provider Name (Legal Business Name): SOHAIL MOHAMMAD ALAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 W THOMAS RD
PHOENIX AZ
85037-3332
US

IV. Provider business mailing address

13640 N PLAZA DEL RIO BLVD
PEORIA AZ
85381-4846
US

V. Phone/Fax

Practice location:
  • Phone: 623-327-7313
  • Fax: 623-327-5437
Mailing address:
  • Phone: 623-876-3800
  • Fax: 623-876-6965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number29300
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: