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General NPI Number Information
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NPI Number | 1225253800
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Entity Type | Individual
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Provider Name | GHASSAN FRAIJ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 1847 E SOUTHERN AVE STE 4
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City | TEMPE
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State | AZ
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Zip | 85282-5881
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Country | US
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Telephone | 480-878-4077
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Fax | 480-489-5269
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Provider Business Mailing Address
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Address Line | PO BOX 45200
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City | PHOENIX
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State | AZ
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Zip | 85064-5200
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Country | US
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Telephone | 804-878-4077
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Fax | 480-489-5269
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 48310
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 48310
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2009-00416
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License Number State | NC
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