Provider Demographics
NPI:1871026484
Name:AMERICAN VASCULAR SPECIALISTS LLC
Entity Type:Organization
Organization Name:AMERICAN VASCULAR SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAMMAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-912-6262
Mailing Address - Street 1:6636 E BASELINE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4430
Mailing Address - Country:US
Mailing Address - Phone:480-912-6262
Mailing Address - Fax:480-912-6261
Practice Address - Street 1:6636 E BASELINE RD STE 100
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4430
Practice Address - Country:US
Practice Address - Phone:480-912-6262
Practice Address - Fax:480-912-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty