Provider Demographics
NPI:1639144850
Name:KALDAWI, EMAD G (MD)
Entity Type:Individual
Prefix:
First Name:EMAD
Middle Name:G
Last Name:KALDAWI
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:PO BOX 12580
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-2580
Mailing Address - Country:US
Mailing Address - Phone:602-467-4757
Mailing Address - Fax:602-371-4960
Practice Address - Street 1:16551 N 103RD WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-8671
Practice Address - Country:US
Practice Address - Phone:602-467-4757
Practice Address - Fax:602-371-4960
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ21238207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZMD21238CMedicare PIN
AZF21991Medicare UPIN