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Individual

HOMAM MOUSSA PACHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4201 SAINT ANTOINE ST # 9C, DETROIT, MI 48201-2153
(313) 745-5146
(313) 745-5146
Mailing address
PO BOX 3539, LAKE HAVASU CITY, AZ 86405-3539
(928) 453-2727
(928) 453-2828

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
67883
AZ
207RI0011X
Interventional Cardiology Physician
67883
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
129869
AZ
Enumeration date
03/27/2016
Last updated
11/18/2024
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