Provider Demographics
NPI:1467779066
Name:ARIZONA HOSPITALISTS, M.D., P.C.
Entity Type:Organization
Organization Name:ARIZONA HOSPITALISTS, M.D., P.C.
Other - Org Name:MAHMOOD SHAHLAPOUR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-825-8575
Mailing Address - Street 1:1042 N HIGLEY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-5398
Mailing Address - Country:US
Mailing Address - Phone:888-825-8575
Mailing Address - Fax:888-406-4076
Practice Address - Street 1:1042 N HIGLEY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-5398
Practice Address - Country:US
Practice Address - Phone:888-825-8575
Practice Address - Fax:888-406-4076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ648967Medicaid