Provider Demographics
NPI:1518953926
Name:HAJI AMOU ASSAR, MAHDIEH
Entity Type:Individual
Prefix:MRS
First Name:MAHDIEH
Middle Name:
Last Name:HAJI AMOU ASSAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 E CLAREMONT ST
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-3713
Mailing Address - Country:US
Mailing Address - Phone:602-954-0819
Mailing Address - Fax:602-271-5466
Practice Address - Street 1:755 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2506
Practice Address - Country:US
Practice Address - Phone:602-271-5207
Practice Address - Fax:602-271-5466
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ321242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology