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NPI Code Detail

MEDICARE: FADI FAHAD MD

MEDICARE:   FADI  FAHAD  MD
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
1207RI0011XInterventional Cardiology Physician62980AZ

General Provider Information

NPI Number : 1871925610
Entity Type Code : Individual
Provider Name (Legal Business Name) : FADI FAHAD MD
Provider Business Mailing Address
First Line : 5750 E HIGHWAY 90 STE 200
Second Line :
City : SIERRA VISTA
State : AZ
Zip : 85635-9113
Country : US
Telephone Number : 520-263-3551
Fax Number :
Provider Business Practice Location Address
First Line : 5750 E HIGHWAY 90 STE 200
Second Line :
City : SIERRA VISTA
State : AZ
Zip : 85635-9113
Country : US
Telephone Number : 520-263-3765
Fax Number : 520-263-3567
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2013
Last Update Date : 02/08/2022

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Directions to “ FADI FAHAD MD” Practice Location

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