Provider Demographics
NPI:1871619601
Name:ABOUZEID, AHMED R (MD)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:R
Last Name:ABOUZEID
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15943 N 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3867
Mailing Address - Country:US
Mailing Address - Phone:207-659-3322
Mailing Address - Fax:623-742-3886
Practice Address - Street 1:10401 W THUNDERBIRD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3004
Practice Address - Country:US
Practice Address - Phone:623-832-5702
Practice Address - Fax:623-832-2931
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ42667207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ551328Medicaid
AZ42667OtherSTATE LICENSE
AZZ140815Medicare PIN
AZ42667OtherSTATE LICENSE