Provider Demographics
NPI:1538128871
Name:MUWAIS, OSAMA WALID
Entity Type:Individual
Prefix:
First Name:OSAMA
Middle Name:WALID
Last Name:MUWAIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:OSAMA
Other - Middle Name:WALID
Other - Last Name:MUWAIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7534 E 2ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-4548
Mailing Address - Country:US
Mailing Address - Phone:480-607-3800
Mailing Address - Fax:480-607-3808
Practice Address - Street 1:7534 E 2ND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-4548
Practice Address - Country:US
Practice Address - Phone:480-607-3800
Practice Address - Fax:480-607-3808
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36816207Q00000X, 208M00000X
CODR.0048684207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ120133-01Medicaid
AZ214987Medicaid
AZ214987Medicaid
AZ214987Medicaid
AZZ114751Medicare PIN
AZZ194876Medicare PIN