Provider Demographics
NPI:1275762130
Name:SETHI, MUHAMMAD JAWAD (MD, MB;BS)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:JAWAD
Last Name:SETHI
Suffix:
Gender:M
Credentials:MD, MB;BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 E BROADWAY BLVD STE A100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3629
Mailing Address - Country:US
Mailing Address - Phone:520-382-1205
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:6365 E TANQUE VERDE RD STE 200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715
Practice Address - Country:US
Practice Address - Phone:520-886-5534
Practice Address - Fax:520-886-5577
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND12928207RE0101X
AZ46978207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ787840Medicaid
ND1459018Medicaid