Healthcare Provider Details

I. General information

NPI: 1093235475
Provider Name (Legal Business Name): FAWAZ ARAIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E. ADAMS ST
SYRACUSE NY
13210
US

IV. Provider business mailing address

750 E. ADAMS ST
SYRACUSE NY
13210
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-1800
  • Fax: 315-464-6238
Mailing address:
  • Phone: 315-464-1800
  • Fax: 315-464-6238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number333977
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: