Organization
INTENSIVISTS OF ARIZONA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANY BAHDOUCH MD (OWNER)
(617) 653-3906
Entity
Organization
Contact information
Practice address
6970 E CHAUNCEY LN STE 105, PHOENIX, AZ 85054-5158
(602) 347-6620
Mailing address
6970 E CHAUNCEY LN STE 105, PHOENIX, AZ 85054-5158
(617) 653-3906
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
930124
—
AZ
Enumeration date
05/19/2020
Last updated
11/04/2020
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