MEDICARE: KHAWAJA CONSULTING, P.C.

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
1	207RC0000X	Cardiovascular Disease Physician	33750	AZ

General Provider Information

NPI Number	:	1780821546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHAWAJA CONSULTING, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 1149
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85380-1149
Country	:	US
Telephone Number	:	623-583-2073
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 W CALLE ESCUDA
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-8022
Country	:	US
Telephone Number	:	623-583-2073
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AZIMUDDIN T KHAWAJA
Credential	:	M.D.
Telephone Number	:	623-583-2073

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	01/28/2009

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