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General NPI Number Information
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NPI Number | 1831358092
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Entity Type | Individual
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Provider Name | WISSAM E. MATTAR MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 9201 E MOUNTAIN VIEW RD STE 105
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5140
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Country | US
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Telephone | 480-587-6614
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Fax | 480-882-5809
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Provider Business Mailing Address
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Address Line | 9201 E MOUNTAIN VIEW RD STE 105
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5140
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Country | US
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Telephone | 480-587-6614
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 59625
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License Number State | AZ
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