1982529459 NPI number — MIRAGE PODIATRY FOOT AND ANKLE SPECIALISTS

Table of content: (NPI 1982529459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982529459 NPI number — MIRAGE PODIATRY FOOT AND ANKLE SPECIALISTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIRAGE PODIATRY FOOT AND ANKLE SPECIALISTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982529459
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20401 N 73RD ST STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85255-4144
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-939-3440
Provider Business Mailing Address Fax Number:
480-939-3448

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20401 N 73RD ST STE 205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85255-4144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-939-3440
Provider Business Practice Location Address Fax Number:
480-939-3448
Provider Enumeration Date:
08/12/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZAFAR
Authorized Official First Name:
HAMMAD
Authorized Official Middle Name:
MOHAMMAD
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
480-358-7970

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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