Organization
IVY LEAGUE ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMEH ASSAD MD (SOLE MEMBER)
(602) 405-9985
Entity
Organization
Contact information
Practice address
7878 N 16TH ST STE 250, PHOENIX, AZ 85020-4478
(602) 308-7802
Mailing address
7878 N 16TH ST STE 250, PHOENIX, AZ 85020-4478
(602) 308-7802
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
943622
—
AZ
Enumeration date
11/06/2018
Last updated
11/06/2018
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