Provider Demographics
NPI:1801820816
Name:NAJIB, AYESHA (MD)
Entity Type:Individual
Prefix:
First Name:AYESHA
Middle Name:
Last Name:NAJIB
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 1:12336 N 91ST ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5053
Mailing Address - Country:US
Mailing Address - Phone:314-322-9450
Mailing Address - Fax:
Practice Address - Street 1:STATE ROUTE 264/US 191
Practice Address - Street 2:SAGE MEMORIAL HOSPITAL
Practice Address - City:GANADO
Practice Address - State:AZ
Practice Address - Zip Code:86505-0457
Practice Address - Country:US
Practice Address - Phone:928-755-4642
Practice Address - Fax:928-755-4589
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116176208000000X
FLME80607208000000X
AZ49404208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036106717Medicaid