Provider Demographics
NPI:1083180996
Name:SAYEGH, JAMIL NAZAR (NMD)
Entity Type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:NAZAR
Last Name:SAYEGH
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 E BROADWAY RD UNIT 3067
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1781
Mailing Address - Country:US
Mailing Address - Phone:914-906-5516
Mailing Address - Fax:
Practice Address - Street 1:16626 E AVENUE OF THE FOUNTAINS STE 201
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-8201
Practice Address - Country:US
Practice Address - Phone:480-219-7133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18-1732175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty