Provider Demographics
NPI:1871116905
Name:AL-ANI, MARWAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARWAN
Middle Name:
Last Name:AL-ANI
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 1:10230 W HAPPY VALLEY PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-4692
Mailing Address - Country:US
Mailing Address - Phone:623-561-3030
Mailing Address - Fax:
Practice Address - Street 1:10230 W HAPPY VALLEY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-4692
Practice Address - Country:US
Practice Address - Phone:623-561-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-23
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ70448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine