Organization
WISSAM FAYAD M.D. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WISSAM A FAYAD M.D. (OWNER)
(928) 344-5565
Entity
Organization
Contact information
Practice address
1841 W 25TH ST, SUITE A, YUMA, AZ 85364-6920
(928) 344-5565
(928) 344-5655
Mailing address
1841 W 25TH ST, SUITE A, YUMA, AZ 85364-6920
(928) 344-5565
(928) 344-5655
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35717
AZ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127246
—
AZ
01
—
Z138627
MEDICARE PTAN
AZ
Enumeration date
07/22/2010
Last updated
02/24/2025
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