Individual
FAEZ A. AYOOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
(602) 655-9184
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
88875
SC
2086S0129X
Vascular Surgery Physician
Primary
88875
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SCO3535019
MEDICARE PIN
SC
Enumeration date
07/16/2012
Last updated
01/24/2025
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