Provider Demographics
NPI:1891552659
Name:CRESCENT MEDICAL
Entity Type:Organization
Organization Name:CRESCENT MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:MUHAMMAD
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-542-1221
Mailing Address - Street 1:5653 S. HWY 95,
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT MOHAVE
Mailing Address - State:AZ
Mailing Address - Zip Code:86426-6068
Mailing Address - Country:US
Mailing Address - Phone:928-768-2558
Mailing Address - Fax:928-768-2875
Practice Address - Street 1:330 S. LOLA LANE
Practice Address - Street 2:SUITE 200
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:928-542-1221
Practice Address - Fax:928-768-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty