Provider Demographics
NPI:1912334988
Name:NAYEF T. RESK MD INC.
Entity Type:Organization
Organization Name:NAYEF T. RESK MD INC.
Other - Org Name:SUNRISE INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANOUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-704-0400
Mailing Address - Street 1:3003 HIGHWAY 95
Mailing Address - Street 2:SUITE 35
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-7896
Mailing Address - Country:US
Mailing Address - Phone:928-704-0400
Mailing Address - Fax:928-704-0400
Practice Address - Street 1:3003 HIGHWAY 95
Practice Address - Street 2:SUITE 35
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7896
Practice Address - Country:US
Practice Address - Phone:928-704-0400
Practice Address - Fax:928-704-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ443324Medicaid
G53968Medicare UPIN
AZ443324Medicaid