Individual
FARES YOUSEF MASANNAT
Active
Individual
FARES YOUSEF MASANNAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
PG PERMIT # 76497
AZ
207RI0200X
Infectious Disease Physician
Primary
7518
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6632250
—
SD
01
—
RAILROAD MEDICARE
P00751793
SD
Enumeration date
06/18/2007
Last updated
08/06/2014
Update your record
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