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General NPI Number Information
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NPI Number | 1386095743
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Entity Type | Individual
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Provider Name | STEVEN MASSAD MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 1851 MESQUITE AVE STE 202
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5681
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Country | US
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Telephone | 928-854-0094
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Fax | 928-680-8986
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Provider Business Mailing Address
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Address Line | 393 LEFFERTS AVE APT 3E
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City | BROOKLYN
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State | NY
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Zip | 11225-4331
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Country | US
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Telephone | 929-248-9028
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 59849
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 59849
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License Number State | AZ
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