Provider Demographics
NPI:1891828695
Name:ARTHRITIS & RHEUMATOLOGY CLINIC PC
Entity Type:Organization
Organization Name:ARTHRITIS & RHEUMATOLOGY CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAKIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-855-4078
Mailing Address - Street 1:1100 S DOBSON RD
Mailing Address - Street 2:1026
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-6157
Mailing Address - Country:US
Mailing Address - Phone:480-855-4078
Mailing Address - Fax:480-855-4081
Practice Address - Street 1:1100 S DOBSON RD
Practice Address - Street 2:1026
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-6157
Practice Address - Country:US
Practice Address - Phone:480-855-4078
Practice Address - Fax:480-855-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29303207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ584210Medicaid
AZZ107103Medicare PIN
AZ584210Medicaid
AZH42889Medicare UPIN