Provider Demographics
NPI:1982678843
Name:FATIMA, UMAIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:UMAIMA
Middle Name:
Last Name:FATIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 E BASELINE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1544
Mailing Address - Country:US
Mailing Address - Phone:480-962-9494
Mailing Address - Fax:480-962-8140
Practice Address - Street 1:2157 E BASELINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1544
Practice Address - Country:US
Practice Address - Phone:480-962-9494
Practice Address - Fax:480-962-8140
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32824207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ971607Medicaid
AZ105002Medicare ID - Type Unspecified
AZH61761Medicare UPIN