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General NPI Number Information
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NPI Number | 1194022269
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Entity Type | Organization
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Legal Business Name | IDEAL INTERNAL MEDICINE SOLUTIONS CORPORATION
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 08/15/2011
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Provider Practice Location Address
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Address Line | 13035 W VISTA PASEO DR
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5572
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Country | US
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Telephone | 480-235-1079
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Fax | 623-374-3579
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Provider Business Mailing Address
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Address Line | 13035 W VISTA PASEO DR
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5572
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Country | US
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Telephone | 480-235-1079
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Fax | 623-374-3579
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Authorized Official
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Title or Position | CEO
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Name | MUZAKEER AHMED SHAIK
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Credential | MD
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Telephone | 480-235-1079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35244
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License Number State | AZ
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