Provider Demographics
NPI:1922483262
Name:AL MUTI, EMAD
Entity Type:Individual
Prefix:
First Name:EMAD
Middle Name:
Last Name:AL MUTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34402 N SCOTTSDALE RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-1226
Mailing Address - Country:US
Mailing Address - Phone:480-595-8019
Mailing Address - Fax:
Practice Address - Street 1:34402 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-1226
Practice Address - Country:US
Practice Address - Phone:480-595-8019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program