Provider Demographics
NPI:1083349385
Name:MUHAJIR, MANA
Entity Type:Individual
Prefix:
First Name:MANA
Middle Name:
Last Name:MUHAJIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MANA
Other - Middle Name:
Other - Last Name:ROUHOLFADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9013 N 24TH AVE STE 1 STW 1925
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021
Mailing Address - Country:US
Mailing Address - Phone:425-999-5676
Mailing Address - Fax:
Practice Address - Street 1:2045 S VINEYARD STE 136
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-6891
Practice Address - Country:US
Practice Address - Phone:480-565-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife