Provider Demographics
NPI:1205571502
Name:DANNAOUI, KAREEM HOUSSAM (MD)
Entity type:Individual
Prefix:
First Name:KAREEM
Middle Name:HOUSSAM
Last Name:DANNAOUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 N 12TH ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2307
Mailing Address - Country:US
Mailing Address - Phone:602-781-3973
Mailing Address - Fax:
Practice Address - Street 1:6525 W SACK DR STE 302
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7107
Practice Address - Country:US
Practice Address - Phone:602-314-9687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-01
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program