Individual
JOSEPH B FARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18404 N TATUM BLVD, SUITE 101, PHOENIX, AZ 85032-1511
(623) 580-5390
(623) 580-5397
Mailing address
2500 W UTOPIA RD, STE. 100, PHOENIX, AZ 85027-4171
(602) 214-6148
(602) 214-6149
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MA06825900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100919
—
AZ
01
—
2Z3840
HEALTHNET
AZ
01
—
7272302
AETNA
AZ
01
—
AZ042595910
BLUE CROSS BLUE SHIELD
AZ
01
—
ZP00349542
MEDICARE RAILROAD
AZ
Enumeration date
01/19/2006
Last updated
09/25/2013
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