Individual
DR. FIDAA J M WISHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016
(602) 933-1213
(602) 933-1214
Mailing address
3200 E CAMELBACK RD STE 250, PHOENIX, AZ 85018-2327
(602) 933-1813
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
58073
AZ
2085P0229X
Pediatric Radiology Physician
A153510
CA
2085R0202X
Diagnostic Radiology Physician
A153510
CA
2085R0202X
Diagnostic Radiology Physician
E-15973
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000999512
DMC CARE
MI
Enumeration date
11/18/2010
Last updated
01/23/2024
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