Provider Demographics
NPI:1326034810
Name:MASOOD, SYED K (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:K
Last Name:MASOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S POWER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-5236
Mailing Address - Country:US
Mailing Address - Phone:480-924-2288
Mailing Address - Fax:480-924-4488
Practice Address - Street 1:215 S POWER RD STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5236
Practice Address - Country:US
Practice Address - Phone:480-924-2288
Practice Address - Fax:480-924-4488
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34358207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ110224402OtherRAIL ROAD MEDICARE
AZ973504Medicaid
AZZ106483Medicare PIN
AZ973504Medicaid