Provider Demographics
NPI:1104016336
Name:ABDEL AZIZ, HIBA I (MD)
Entity Type:Individual
Prefix:DR
First Name:HIBA
Middle Name:
Last Name:ABDEL AZIZ
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16601 N 40TH ST STE 227
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3354
Mailing Address - Country:US
Mailing Address - Phone:602-633-3721
Mailing Address - Fax:602-595-1127
Practice Address - Street 1:16601 N 40TH ST STE 227
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3354
Practice Address - Country:US
Practice Address - Phone:602-633-3721
Practice Address - Fax:602-595-1127
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.007748208600000X
AZ576772086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH020991OtherMEDICARE PTAN
OH3080065Medicaid
AZ005317Medicaid