Provider Demographics
NPI:1689980088
Name:THE ARIZONA CENTER FOR COLON AND RECTAL DISEASES, PLLC
Entity Type:Organization
Organization Name:THE ARIZONA CENTER FOR COLON AND RECTAL DISEASES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-591-7649
Mailing Address - Street 1:14420 W MEEKER BLVD
Mailing Address - Street 2:201
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5286
Mailing Address - Country:US
Mailing Address - Phone:623-544-4600
Mailing Address - Fax:623-544-4725
Practice Address - Street 1:14420 W MEEKER BLVD
Practice Address - Street 2:201
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5286
Practice Address - Country:US
Practice Address - Phone:623-544-4600
Practice Address - Fax:623-544-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40932208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty