# SAMER MUALA MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912367459
- **Authorized official:** SAMER MOHD FARUQ MUALA M.D. (SOLE OWNER)
- **Authorized official phone:** (702) 453-3799

## Contact information

- **Practice address:** 520 ROSE LN, WICKENBURG, AZ 85390-1447
- **Practice address phone:** (702) 453-3799
- **Practice address fax:** (702) 453-5741
- **Mailing address:** 14175 W INDIAN SCHOOL RD STE B4-498, GOODYEAR, AZ 85395-8407
- **Mailing address phone:** (702) 453-3799
- **Mailing address fax:** (702) 453-5741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 48268 | AZ | Yes |

## Other

- **Enumeration date:** 02/25/2016
- **Last updated:** 02/25/2016