Provider Demographics
NPI:1497787642
Name:ELGHOUL, ZIAD MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIAD
Middle Name:MICHAEL
Last Name:ELGHOUL
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 1:1960 W FRYE RD
Mailing Address - Street 2:BUILDING A, SUITE 5
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6238
Mailing Address - Country:US
Mailing Address - Phone:480-917-5900
Mailing Address - Fax:480-917-2255
Practice Address - Street 1:1960 W FRYE RD
Practice Address - Street 2:BUILDING A, SUITE 5
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6238
Practice Address - Country:US
Practice Address - Phone:480-917-5900
Practice Address - Fax:480-917-2255
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29317207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH54379Medicare UPIN