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General NPI Number Information
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NPI Number | 1588050033
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Entity Type | Individual
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Provider Name | GHAZWAN ELIAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2015
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 1910 E THOMAS RD STE 101
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City | PHOENIX
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State | AZ
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Zip | 85016-7766
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Country | US
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Telephone | 480-470-0003
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Fax | 480-470-0004
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Provider Business Mailing Address
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Address Line | PO BOX 4417
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City | HOUSTON
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State | TX
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Zip | 77210-4417
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Country | US
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Telephone | 480-470-0003
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Fax | 480-470-0004
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | S1392
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 66208
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License Number State | AZ
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