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General NPI Number Information
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NPI Number | 1154773463
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Entity Type | Organization
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Legal Business Name | MARWAN GHAZOUL MD PC
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 4240 E MARLETTE AVE
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-3960
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Country | US
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Telephone | 602-708-9276
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Fax |
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Provider Business Mailing Address
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Address Line | 4240 E MARLETTE AVE
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-3960
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Country | US
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Telephone | 602-708-9276
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARWAN GHAZOUL
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Credential | MD
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Telephone | 602-708-9276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 18744
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License Number State | AZ
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