Healthcare Provider Details

I. General information

NPI: 1649405812
Provider Name (Legal Business Name): MAZEN ROUMIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 N SCOTTSDALE RD STE B120
SCOTTSDALE AZ
85253-3555
US

IV. Provider business mailing address

7373 N SCOTTSDALE RD STE B120
SCOTTSDALE AZ
85253-3555
US

V. Phone/Fax

Practice location:
  • Phone: 480-718-5072
  • Fax: 480-718-5074
Mailing address:
  • Phone: 480-718-5072
  • Fax: 480-718-5074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number73153
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number73153
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: