Healthcare Provider Details

I. General information

NPI: 1316946445
Provider Name (Legal Business Name): AL SHAAFI MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5861 N ORACLE RD
TUCSON AZ
85704-3813
US

IV. Provider business mailing address

5861 N ORACLE RD
TUCSON AZ
85704-3813
US

V. Phone/Fax

Practice location:
  • Phone: 520-293-6686
  • Fax: 520-887-1736
Mailing address:
  • Phone: 520-293-6686
  • Fax: 520-887-1736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: MOHAMMED N NOMAAN
Title or Position: PRESIDENT
Credential: MD
Phone: 520-293-6686