Healthcare Provider Details

I. General information

NPI: 1689679771
Provider Name (Legal Business Name): ANWAR ABDEL-RAHMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 E THOMAS RD #124
SCOTTSDALE AZ
85251-5844
US

IV. Provider business mailing address

8111 E THOMAS RD #124
SCOTTSDALE AZ
85251-5844
US

V. Phone/Fax

Practice location:
  • Phone: 602-954-0444
  • Fax: 602-952-7146
Mailing address:
  • Phone: 602-954-0444
  • Fax: 602-952-7146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number28403
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: