Provider Demographics
NPI:1568959252
Name:MOWZOON, MIA (MD)
Entity Type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:MOWZOON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9745 N 90TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5066
Mailing Address - Country:US
Mailing Address - Phone:480-661-1485
Mailing Address - Fax:480-393-1970
Practice Address - Street 1:9745 N 90TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5066
Practice Address - Country:US
Practice Address - Phone:480-661-1485
Practice Address - Fax:480-393-1970
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ65930207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology