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NPI Code Detail

MEDICARE: DR. NAEEM AMANULLAH PATHAN M.D.

MEDICARE: DR. NAEEM AMANULLAH PATHAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0805XGeriatric Psychiatry Physician17016AZ

General Provider Information

NPI Number : 1366506263
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NAEEM AMANULLAH PATHAN M.D.
Provider Business Mailing Address
First Line : 12145 EAST LUPINE AVE,
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259
Country : US
Telephone Number : 480-474-4779
Fax Number :
Provider Business Practice Location Address
First Line : 3450 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2331
Country : US
Telephone Number : 602-265-8338
Fax Number : 602-265-8377
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 09/18/2008

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