Provider Demographics
NPI:1376654293
Name:KARTOUMAH, ALMUTAZ B (MD)
Entity Type:Individual
Prefix:
First Name:ALMUTAZ
Middle Name:B
Last Name:KARTOUMAH
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 1:3333 E CAMELBACK RD STE 180
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2396
Mailing Address - Country:US
Mailing Address - Phone:602-997-0484
Mailing Address - Fax:602-944-6882
Practice Address - Street 1:655 S DOBSON RD STE 214
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5671
Practice Address - Country:US
Practice Address - Phone:480-857-2381
Practice Address - Fax:480-857-2407
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36720207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ207120Medicaid
AZ116994Medicare PIN