1952636169 NPI number — DR. RASHEEDAT ABDUL-AZEEZ M.D

Table of content: DR. RASHEEDAT ABDUL-AZEEZ M.D (NPI 1952636169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952636169 NPI number — DR. RASHEEDAT ABDUL-AZEEZ M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABDUL-AZEEZ
Provider First Name:
RASHEEDAT
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AROJOJOYE
Provider Other First Name:
RASHEEDAT
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952636169
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5720 W CHANDLER BLVD
Provider Second Line Business Mailing Address:
BLDG C, STE 3
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85226-3359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-904-5040
Provider Business Mailing Address Fax Number:
602-714-8114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5720 W CHANDLER BLVD
Provider Second Line Business Practice Location Address:
BLDG C, STE 3
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85226-3359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-904-5040
Provider Business Practice Location Address Fax Number:
602-714-8114
Provider Enumeration Date:
10/06/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  46673 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 723893 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".