Provider Demographics
NPI:1255645891
Name:ASHAMALLA, HANY S (MD, MSC)
Entity type:Individual
Prefix:
First Name:HANY
Middle Name:S
Last Name:ASHAMALLA
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14811 W BELL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7602
Mailing Address - Country:US
Mailing Address - Phone:623-328-7323
Mailing Address - Fax:623-337-4917
Practice Address - Street 1:14811 W BELL RD STE 102
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7602
Practice Address - Country:US
Practice Address - Phone:623-328-7323
Practice Address - Fax:623-337-4917
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1134992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry