Provider Demographics
NPI:1851077051
Name:SOLIMAN, DIAA MAMDOUH MOHAMED (MD)
Entity Type:Individual
Prefix:
First Name:DIAA
Middle Name:MAMDOUH MOHAMED
Last Name:SOLIMAN
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 1:405 E PRINCE RD APT 823
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-6153
Mailing Address - Country:US
Mailing Address - Phone:520-665-8889
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF ARIZONA 1501 N CAMPBELL AVE ROOM 4301
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR80220390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program