Provider Demographics
NPI:1932290897
Name:M ZUHDI JASSER MD PC
Entity Type:Organization
Organization Name:M ZUHDI JASSER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:M
Authorized Official - Middle Name:ZUHDI
Authorized Official - Last Name:JASSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-251-3122
Mailing Address - Street 1:1010 E MCDOWELL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2609
Mailing Address - Country:US
Mailing Address - Phone:602-251-3122
Mailing Address - Fax:602-254-1226
Practice Address - Street 1:1010 E MCDOWELL RD STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2609
Practice Address - Country:US
Practice Address - Phone:602-251-3122
Practice Address - Fax:602-254-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27073207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ85372Medicare PIN