Healthcare Provider Details

I. General information

NPI: 1598229767
Provider Name (Legal Business Name): FATUMA AHMED PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7351 E OSBORN RD STE 200B
SCOTTSDALE AZ
85251-6451
US

IV. Provider business mailing address

7351 E OSBORN RD STE 200B
SCOTTSDALE AZ
85251-6451
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-5730
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11314
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number56659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: